Paracoccidioidomycosis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with acute paracoccidioidomycosis usually have an ill appearing, and chronic PMC patients can appear healthy at early stages. Physical examination of patients with juvenile PMC is usually remarkable for node swelling, hepatomegaly, and esplenomegaly. The presence of pulmonary abnormalities and skin lesions on physical examination is suggestive of adult PMC. <ref name=a>Vargas J, Vargas R. Paracoccidioidomicosis. ''Rev. enferm. infecc. trop. ''2009;1(1):49-56</ref>
Patients with [[Acute (medical)|acute]] paracoccidioidomycosis usually appear ill. Chronic PCM patients can appear healthy at early stages. Physical examination of patients with juvenile PCM is usually remarkable for [[lymphadenopathy]] and [[hepatosplenomegaly]]. Adult PCM is characterized by the presence of pulmonary abnormalities and skin lesions.<ref name="a">Vargas J, Vargas R. Paracoccidioidomicosis. ''Rev. enferm. infecc. trop. ''2009;1(1):49-56</ref>


==Physical Examination Acute/Subacute/Juvenile==
==Physical Examination Acute/Subacute/Juvenile==
===Appearance of the Patient===
===Appearance of the Patient===
*Weight loss
*[[Weight loss]]


===Vital Signs===
===Vital Signs===
*Fever
*[[Fever]]


===Skin===
===Skin===
*Pallor
*[[Pallor]]
*Jaundice
*[[Jaundice]]
*Cutaneous lesions
*[[Skin lesions|Cutaneous lesions]]


===Neck===
===Neck===
*Lymphadenopathy (cervical)
*[[Lymphadenopathy]] (cervical)
*Lymph node fistulization
*Lymph node [[Fistula|fistulization]]


===Abdomen===
===Abdomen===
*Hepatomegaly
*[[Hepatomegaly]]
*Splenomegaly
*[[Splenomegaly]]
*Abdominal pain
*[[Abdominal tenderness]]
*Lymphadenopathy
*[[Lymphadenopathy]]


===Genitourinary===
===Genitourinary===
*Lymphadenopathy (inguinal)
*[[Lymphadenopathy]] (inguinal)
 
=== Extremities ===
* [[Osteoarticular pain]]


==Physical Examination Chronic/Adult==
==Physical Examination Chronic/Adult==
===Appearance of the Patient===
===Appearance of the Patient===
* Weight loss
* [[Weight loss]]


===Vital Signs===
===Vital Signs===
*Fever
*[[Fever]]
*[[Tachypnea]]
*[[Hypoxemia]]


===Skin===
===Skin===
*Pallor
*[[Pallor]]
*Cutaneous lesions
*[[Skin lesions|Cutaneous lesions]]


===HEENT===
===HEENT<ref name="a">Vargas J, Vargas R. Paracoccidioidomicosis. ''Rev. enferm. infecc. trop. ''2009;1(1):49-56</ref>===
*Cutaneous lesions: Erythematous ulcers (lip, tongue, palate, cheek, nose, larynx) <ref name=a>Vargas J, Vargas R. Paracoccidioidomicosis. ''Rev. enferm. infecc. trop. ''2009;1(1):49-56</ref>
*[[Skin lesions|Cutaneous lesions]]: Erythematous ulcers (lip, tongue, palate, cheek, nose, larynx)


===Neck===
===Neck===
*Lymphadenopathy (cervical)
*[[Lymphadenopathy]] (cervical)
*Lymph node fistulization
*Lymph node [[Fistula|fistulization]]


===Lungs===
===Lungs===
*Velcro crackles: Fibrosis
*Velcro [[crackles]]
**Suggestive of [[fibrosis]]


===Abdomen===
===Abdomen===
*Abdominal pain
*[[Abdominal tenderness]]
*Lymphadenopathy
*[[Lymphadenopathy]]


===Genitourinary===
===Genitourinary<ref name="g">Vignolles M, Melo V, Paniagua B, Giménez M,  Piccoli L. Paracoccidioidomicosis genital: localización infrecuente. ''Arch. Argent. Dermatol. ''2015;65(2):54-56</ref><ref name="pmid10742725">{{cite journal| author=Severo LC, Kauer CL, Oliveira Fd, Rigatti RA, Hartmann AA, Londero AT| title=Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature. | journal=Rev Inst Med Trop Sao Paulo | year= 2000 | volume= 42 | issue= 1 | pages= 38-40 | pmid=10742725 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10742725  }} </ref>===
*Lymphadenopathy (inguinal)
*[[Lymphadenopathy]] (inguinal)
*Scotal swelling: Genital PMC
*[[Scrotal swelling]]
*Testicle tumor: Genital PMC
**May be present in Genital PCM
*Penile ulcers: Genital PMC <ref name=g>Vignolles M, Melo V, Paniagua B, Giménez M,  Piccoli L. Paracoccidioidomicosis genital: localización infrecuente. ''Arch. Argent. Dermatol. ''2015;65(2):54-56</ref> <ref name="pmid10742725">{{cite journal| author=Severo LC, Kauer CL, Oliveira Fd, Rigatti RA, Hartmann AA, Londero AT| title=Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature. | journal=Rev Inst Med Trop Sao Paulo | year= 2000 | volume= 42 | issue= 1 | pages= 38-40 | pmid=10742725 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10742725  }} </ref>
*Testicle tumor
**May be present in Genital PCM
*Penile ulcers
**May be present in Genital PCM


===Extremities===
===Extremities===
*Osteoarticular pain
*[[Osteoarticular pain]]
*Osteoarticular tumefaction
*Osteoarticular tumefaction


===Neuromuscular===
===Neuromuscular<ref name="h">Francesconi F, Da Silva MT, Costa RL, Francesconi VA, Carregal E, Talhari S, Valle AC.. PLong-term outcome of neuroparacoccidioidomycosis treatment. ''Rev Soc Bras Med Trop.''2011;44(1):22-25</ref>===
*Muscle weakness
*Muscle weakness
*Positive Romberg's test: in neuroparacoccidioidomycosis <ref name=h>Francesconi F, Da Silva MT, Costa RL, Francesconi VA, Carregal E, Talhari S, Valle AC.. PLong-term outcome of neuroparacoccidioidomycosis treatment. ''Rev Soc Bras Med Trop.''2011;44(1):22-25</ref>
*Positive [[Romberg's test]]: in neuroparacoccidioidomycosis


==References==
==References==

Latest revision as of 22:13, 12 February 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac

Overview

Patients with acute paracoccidioidomycosis usually appear ill. Chronic PCM patients can appear healthy at early stages. Physical examination of patients with juvenile PCM is usually remarkable for lymphadenopathy and hepatosplenomegaly. Adult PCM is characterized by the presence of pulmonary abnormalities and skin lesions.[1]

Physical Examination Acute/Subacute/Juvenile

Appearance of the Patient

Vital Signs

Skin

Neck

Abdomen

Genitourinary

Extremities

Physical Examination Chronic/Adult

Appearance of the Patient

Vital Signs

Skin

HEENT[1]

Neck

Lungs

Abdomen

Genitourinary[2][3]

  • Lymphadenopathy (inguinal)
  • Scrotal swelling
    • May be present in Genital PCM
  • Testicle tumor
    • May be present in Genital PCM
  • Penile ulcers
    • May be present in Genital PCM

Extremities

Neuromuscular[4]

  • Muscle weakness
  • Positive Romberg's test: in neuroparacoccidioidomycosis

References

  1. 1.0 1.1 Vargas J, Vargas R. Paracoccidioidomicosis. Rev. enferm. infecc. trop. 2009;1(1):49-56
  2. Vignolles M, Melo V, Paniagua B, Giménez M, Piccoli L. Paracoccidioidomicosis genital: localización infrecuente. Arch. Argent. Dermatol. 2015;65(2):54-56
  3. Severo LC, Kauer CL, Oliveira Fd, Rigatti RA, Hartmann AA, Londero AT (2000). "Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature". Rev Inst Med Trop Sao Paulo. 42 (1): 38–40. PMID 10742725.
  4. Francesconi F, Da Silva MT, Costa RL, Francesconi VA, Carregal E, Talhari S, Valle AC.. PLong-term outcome of neuroparacoccidioidomycosis treatment. Rev Soc Bras Med Trop.2011;44(1):22-25