Listeriosis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Febrile Gastroenteritis
Appearance of the Patient
A patient with listeriosis will likely appear ill, complaining of fever, "body pain" and chills. Depending on the previous health status of the patient, the initial presentation may change, since this is an important factor in the evolution of the disease.
Vitals
Temperature
- A fever is often present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
- Pallor may be present
Throat
- Mucous membranes may be dehydrated
Abdomen
- Abdominal distention may be present
- Abdominal tenderness may be present
Infection in Pregnancy
Pregnant women with listeriosis often present with flu-like symptoms. Unborn infants sustain the most severe complications, such as fetal death, stillbirth or meningitis.[1]
Sepsis of Unknown Origin
Vitals
Temperature
- A fever is often present
- Hypothermia may be present
Pulse
Rate
- Tachycardia is often present
Strength
- Peripheral pulses may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Throat
- Mucous membranes may be dehydrated
Neck
- Lymph nodes may be present
Abdomen
- Abdominal tenderness may be present
Extremities
- Cyanosis may be present
Neurologic
- Mental status may be altered
CNS Infection
Meningoencephalitis
Appearance of the Patient
A patient with meningoencephalitis may have a wide range of presentations. These may range from mild focal neurologic signs to coma.
Vitals
Temperature
- A fever is often present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Head
- Bulging fontanelles may be present(neonates)
Neck
- Neck stiffness may be present
Neurologic
- Mental status may be altered
- Coma may be present
- Seizures may be present
- Focal neurologic signs may be present
Encephalitis
Appearance of the Patient
A patient with encephalitis may have a wide range of presentations. These may range from personality changes, mild focal neurologic signs, to coma.
Vitals
Temperature
- A fever is often present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Head
- Bulging fontanelles may be present (neonates)
Neck
- Neck stiffness may be present
Throat
- Mucosal rash may be present
Neurologic
- Mental status may be altered
- Coma may be present
- Seizures may be present
- Focal neurologic signs may be present
- Autonomic dysfunction may be present
- Hemiparesis may be present
- Ataxia may be present
- Dystonia may be present
Rhombencephalitis
Appearance of the Patient
Commonly in previously healthy patients. The disease usually progresses in two phases: in the initial phase, patient may be febrile with nausea and vomiting; in the second phase, there is usually cranial nerve palsies, tremor, ataxia and altered consciousness.
Vitals
Temperature
- A fever is often present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Head
- Bulging fontanelles may be present (neonates)
Neck
- Neck stiffness may be present
Lungs
Respiratory failure is present in half of the patients
Throat
- Mucosal rash may be present
Neurologic
- Mental status may be altered
- Coma may be present
- Seizures may be present
- Focal neurologic signs may be present
- Autonomic dysfunction may be present
- Hemiparesis may be present
- Ataxia may be present
- Dystonia may be present
- Tremor may be present
Brain abscess
Appearance of the Patient
Patients often complain of headache, drowsiness, confusion, speech difficulties and fever with a rapidly progressive course. These manifestations are a combination of increased intracranial pressure (due to a space-occupying lesion), infection, and focal neurologic brain tissue damage.
Vitals
Temperature
- A fever may be present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Head
- Bulging fontanelles may be present (neonates)
Eyes
- Papilledema may be present
Neck
- Neck stiffness may be present
Lungs
Respiratory failure is present in half of the patients
Throat
- Mucosal rash may be present
Neurologic
- Mental status may be altered
- Coma may be present
- Speech difficulties may be present
- Seizures may be present
- Focal neurologic signs may be present
- Autonomic dysfunction may be present
- Hemiparesis may be present
- Ataxia may be present
- Dystonia may be present
- Tremor may be present
Spinal cord infection
Vitals
Temperature
- A fever may be present
Pulse
Rate
- Tachycardia may be present
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present
Skin
Head
- Bulging fontanelles may be present (neonates)
Eyes
- Papilledema may be present
Neck
- Neck stiffness may be present
Lungs
Respiratory failure is present in half of the patients
Throat
- Mucosal rash may be present
Abdomen
Extremities
- Decreased strength may be present
Neurologic
- Mental status may be altered
- Coma may be present
- Seizures may be present
- Focal neurologic signs may be present
- Autonomic dysfunction may be present
- Hemiparesis may be present
- Ataxia may be present
- Dystonia may be present
- Tremor may be present