Typhus physical examination: Difference between revisions

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{{Typhus}}
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==Overview==
{{CMG}}
Typhus fever presents with high grade [[fever]] and a [[maculopapular rash]]. [[Generalized lymphadenopathy]] is present in majority of the patients.  Physical examination usually reveal combination of several non-specific findings.<ref name="urlEpidemic Typhus">{{cite web |url=https://www.cdc.gov/typhus/epidemic/index.html |title=Epidemic Typhus |format= |work= |accessdate=}}</ref><ref name="urlMurine Typhus">{{cite web |url=https://www.cdc.gov/typhus/murine/index.html |title=Murine Typhus |format= |work= |accessdate=}}</ref><ref name="urlScrub Typhus">{{cite web |url=https://www.cdc.gov/typhus/scrub/index.html |title=Scrub Typhus |format= |work= |accessdate=}}</ref>
==Physical Examination==
===Vital Signs===
* Temperature raised as high as 104<sup>o</sup>F
 
* Low blood pressure
 
===Skin===
 
* A maculopapular, vesicular, or petechial rash or an eschar at the site of  the tick bite.  
 
* The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade.
 
* People with severe typhus may also develop small areas of bleeding into the skin ([[petechiae]]).


==Physical examination==
==Physical examination==
===Vitals===
===Vitals===
*Fever
*[[Fever]] (as high as 104oF)
*Bradycardia
*[[Bradycardia]]
*Tachypnea and cough
*[[Tachypnea]] and [[cough]]
===HEENT===
*[[Red eye|Conjunctival redness]] occurs in scrub typhus.


===Skin===
===Skin===
*Rash
*A [[Maculopapular|maculopapula]]<nowiki/>r, or [[petechial rash]] initially appears on the trunk and axilla and spreads to involve the rest of the body except for the face, palms, and soles.
The macular, maculopapular, or petechial rash initially occurs on the trunk and axilla and spreads to involve the rest of the body except for the face, palms, and soles.
*Rash is [[petechia]]<nowiki/>l in patients with [[epidemic]] or [[Murine typhus|murine typhus.]]
Rash may be petechial in patients with epidemic or murine typhus.
*[[Eschar]] is found in the [[Scrub typhus|scrub]] form of typhus and is diagnostic. Eschar develops at the site of the arthropod bite as a painless papule. It then becomes indurated and enlarged. The center of the lesion becomes necrotic and develops into a black scab.
*Eschar
 
This is found in the scrub form of typhus and is essential in confirming a clinical diagnosis. It occurs in up to 60% of cases.
Eschar occurs at the site of the arthropod bite. It starts as a painless papule, and the lesion becomes indurated and enlarged. The center of the lesion becomes necrotic and develops into a black scab.
Other features
===Lymph nodes===
===Lymph nodes===
Regional lymphadenopathy
*[[Generalized lymphadenopathy]]
Lymph nodes are often tender and enlarged.
*Lymph nodes are often tender and enlarged.
Generalized lymphadenopathy
 
===Abdomnen===
===Abdomnen===
*Hepatomegaly
*[[Hepatomegaly]]
*Splenomegaly
*[[Splenomegaly]]
===HEENT===
Conjunctival suffusion occurs in scrub typhus.
 
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 00:32, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Typhus fever presents with high grade fever and a maculopapular rash. Generalized lymphadenopathy is present in majority of the patients. Physical examination usually reveal combination of several non-specific findings.[1][2][3]

Physical examination

Vitals

HEENT

Skin

  • A maculopapular, or petechial rash initially appears on the trunk and axilla and spreads to involve the rest of the body except for the face, palms, and soles.
  • Rash is petechial in patients with epidemic or murine typhus.
  • Eschar is found in the scrub form of typhus and is diagnostic. Eschar develops at the site of the arthropod bite as a painless papule. It then becomes indurated and enlarged. The center of the lesion becomes necrotic and develops into a black scab.

Lymph nodes

Abdomnen

References

  1. "Epidemic Typhus".
  2. "Murine Typhus".
  3. "Scrub Typhus".

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