West nile virus physical examination: Difference between revisions

Latest revision as of 02:09, 12 September 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

On physical examination, patients with WNV infection may have no specific signs. Physical examination findings may range from an isolated fever to signs of severe neurological impairment, meningeal irritation, stupor, and coma.

Physical exam

Most patients with WNV are asymptomatic or experience a mild disease that may often have no signs on physical examination.^[1]

Vital signs

Skin

Macular or papular truncal rash

HEENT

Chest

Ataxic or apneustic breathing

Abdomen

Neurologic

References

↑ Sejvar JJ, Haddad MB, Tierney BC, Campbell GL, Marfin AA, Van Gerpen JA; et al. (2003). "Neurologic manifestations and outcome of West Nile virus infection". JAMA. 290 (4): 511–5. doi:10.1001/jama.290.4.511. PMID 12876094. Review in: ACP J Club. 2004 May-Jun;140(3):78

[pmid12876094-1] Sejvar JJ, Haddad MB, Tierney BC, Campbell GL, Marfin AA, Van Gerpen JA; et al. (2003). "Neurologic manifestations and outcome of West Nile virus infection". JAMA. 290 (4): 511–5. doi:10.1001/jama.290.4.511. PMID 12876094. Review in: ACP J Club. 2004 May-Jun;140(3):78

[1]

@@ Line 1: / Line 1: @@
 {{West nile virus}}
 {{CMG}}
-{{MJM}}
 ==Overview==
-On physical examination, patients with WNV infection may have no specific signs. Physical examination findings may range from isolated fever and tachycardia to sensory and motor neurological impairment, signs of meningeal irritation, stupor, and coma.
+On physical examination, patients with WNV infection may have no specific signs. Physical examination findings may range from an isolated fever to signs of severe neurological impairment, meningeal irritation, stupor, and coma.
 ==Physical exam==
-Most patients with WNV are asymptomatic or experience a mild disease that may often have no signs on physical examination.
+Most patients with WNV are asymptomatic or experience a mild disease that may often have no signs on physical examination.<ref name="pmid12876094">{{cite journal| author=Sejvar JJ, Haddad MB, Tierney BC, Campbell GL, Marfin AA, Van Gerpen JA et al.| title=Neurologic manifestations and outcome of West Nile virus infection. | journal=JAMA | year= 2003 | volume= 290 | issue= 4 | pages= 511-5 | pmid=12876094 | doi=10.1001/jama.290.4.511 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12876094  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15122841 Review in: ACP J Club. 2004 May-Jun;140(3):78] </ref>
-It is possible for a patient with West nile virus to present with signs of [[encephalitis]] and [[meningoencephalitis]]. These signs include:
+===Vital signs===
+* [[Fever]]
+* [[Tachycardia]]
+* [[Tachypnea]]
-*[[Stupor]]
+===Skin===
-*[[Coma]]
+* [[Macular]] or [[papular]] truncal [[rash]]
-*[[Confusion]]
-Other clinical findings can include things such as:
+===HEENT===
+* [[Papilledema]]
+* [[Nystagmus]]
+* [[Lymphadenopathy]]
+* Non exudative [[pharyngeal erythema]]
-*[[Papilledema]]
+===Chest===
-*[[Cranial nerve]] involvement
+*Ataxic or apneustic breathing
-*Decreased [[sensation]]
-*[[hyperreflexia]]
+===Abdomen===
-*Positive [[Brudzinki signs]] and [[Kernig signs]]
+* [[Abdominal tenderness]]
-*Motor strength weakness
+* [[Splenomegaly]]
+* [[Vesical fullness]]
+===Neurologic===
+* [[Altered mental status]]
+* [[Tremor]]
+* [[Myoclonus]]
+* [[Bradykinesia]]
+* [[Rigidity]]
+* [[Absent corneal reflex]]
+* [[Absent gag reflex]]
+* [[Memory loss]]
+* [[Sensory loss]]
+* [[Motor weakness]]
+* [[Neck stiffness]]
+* Positive Kernig and Brudzinski tests
+* [[Hyperreflexia]]
+* Positive Babinski reflex
 ==References==
 {{Reflist|2}}