Ebola physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]; João André Alves Silva, M.D. [3]
Overview
Ebola is commonly associated with the acute onset of high fever, chills and hemorrhage as well as swollen joints, weakness, rash and red eyes.[1][2][3]
Physical Examination
Appearance of the Patient
The general appearance of the patient will depend on the stage of the disease. Common presentations include a patient who shows prostration, who may be nauseated and vomiting, with shortness of breath and dysphagia and possibly showing some kind of hemorrhage, most typically retinal and/or bleeding gums. In later stages of the disease, the patient might present with convulsions or be in shock.[4]
Vitals
Temperature
- High fever is often present
Pulse
Rate
- Tachycardia
- Relative bradycardia
Rhythm
- The pulse is often regular
Strength
- The pulse may be weak, in cases of dehydration and hemorrhage
Symmetry
- The pulses are often symmetric
Blood Pressure
- Hypotension (less than 90 mmHg of SBP and 60 mmHg of DBP) is typically present
- Postural hypotension may be present
Respiratory Rate
- Signs of respiratory difficulty may be present, such as:
- Intercostal retractions
- Paradoxical breathing
- Nasal flare
- Tachypnea - fatal cases often present with tachypnea; survivors are not tachypneic
Skin
Hemorrhagic manifestations tend to occur during the more severe stages of the disease and may include:[1]
- Maculopapular rash on the trunk, usually between the 5th and 7th day of the condition, associated with different stages of erythema and desquamation, which is a valuable finding in differentiating Ebola from other diseases
- Petechiae is a common finding
- Ecchymoses is a common finding
- Mucosal hemorrhages is a common finding
- Uncontrolled bleeding from venipuncture locals is a common finding
Eyes
- Conjunctival injection is a common finding
Nose
- Epistaxis may be present.
- Nasal discharge may be present.[1]
Throat
- Mucosal hyperemia of the oral cavity is a common finding.
- Bleeding gums is a common finding.
Abdomen
- Abdominal tenderness may suggest pancreatitis, intestinal swelling, or mesenteric lymphadenopathy
- Abdominal distention may suggest paralytic ileus
Extremities
- Edema may be present.
Neurologic
- Obtundation may be present.[5][6][7]
References
- ↑ 1.0 1.1 1.2 Feldmann, Heinz; Geisbert, Thomas W (2011). "Ebola haemorrhagic fever". The Lancet. 377 (9768): 849–862. doi:10.1016/S0140-6736(10)60667-8. ISSN 0140-6736.
- ↑ Formenty, Pierre; Hatz, Christophe; Le Guenno, Bernard; Stoll, Agnés; Rogenmoser, Philipp; Widmer, Andreas (1999). "Human Infection Due to Ebola Virus, Subtype Côte d'Ivoire: Clinical and Biologic Presentation". The Journal of Infectious Diseases. 179 (s1): S48–S53. doi:10.1086/514285. ISSN 0022-1899.
- ↑ Gradon J (2000). "An outbreak of Ebola virus: lessons for everyday activities in the intensive care unit". Crit Care Med. 28 (1): 284–5. PMID 10667555.
- ↑ Borchert, Matthias; Mutyaba, Imaam; Van Kerkhove, Maria D; Lutwama, Julius; Luwaga, Henry; Bisoborwa, Geoffrey; Turyagaruka, John; Pirard, Patricia; Ndayimirije, Nestor; Roddy, Paul; Van der Stuyft, Patrick (2011). "Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned". BMC Infectious Diseases. 11 (1): 357. doi:10.1186/1471-2334-11-357. ISSN 1471-2334.
- ↑ Ndambi R, Akamituna P, Bonnet MJ, Tukadila AM, Muyembe-Tamfum JJ, Colebunders R (1999). "Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995". J Infect Dis. 179 Suppl 1: S8–10. doi:10.1086/514297. PMID 9988156.
- ↑ Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y; et al. (1999). "Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients". J Infect Dis. 179 Suppl 1: S1–7. doi:10.1086/514308. PMID 9988155.
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.