Malaria physical examination: Difference between revisions

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Latest revision as of 18:00, 18 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Physical findings in malaria may include fever, weakness, pallor, jaundice, and perspiration. Other findings on physical exam are tachycardia, tachypnea, splenomegaly, and hepatomegaly.

Physical Examination

Appearance of the Patient

The appearance of the patient depends on the stage of the disease. The patient may be ill-looking, shivering, and/or sweating. After the fever episode, patients appear extremely tired and sleepy. In more severe cases of the disease, the patient may appear anemic, with jaundice, or even in coma.^[1]

Vitals

Temperature

A fever is often present

Pulse

Rate

Tachycardia may be present

Blood Pressure

Hypotension may be present (in severe cases of the disease)

Respiratory Rate

Tachypnea may be present

Skin

Cyanosis may be present (in severe cases of the disease, where there may be respiratory distress)
Jaundice may be present (in severe anemia)
Pallor may be present
Petechiae may be present (in severe cases of the disease, when there is thrombocytopenia)

Eyes

Icteric sclera may be present (in severe anemia with jaundice)
Conjunctivae may be pale

Nose

Alar flare (in severe cases of the disease, where there may be respiratory distress)

Throat

The throat may be erythematous

Lungs

Pulmonary edema may be present
Consolidation may be present with reduced breath sounds auscultated (rarely)
Intercostal retraction may be present (in severe cases of the disease, where there may be respiratory distress)

Abdomen

Abdominal distention may be present
Hepatomegaly may be present
Splenomegaly may be present

Genitourinary

Hematuria may be present (in severe hemolysis)

Extremities

Cyanosis may be present (in severe anemia)
Edema may be present (in severe disease, where there may be renal failure)

Neurologic

Coma may be present (in cerebral malaria)
Mental status may be altered
Convulsions may occur

References

↑ "Malaria".

Template:WikiDoc Sources

[CDC-1] "Malaria".

[1]

@@ Line 2: / Line 2: @@
 {{Malaria}}
 {{CMG}}; {{AE}} {{JS}}
+==Overview==
-==Overview==
+Physical findings in malaria may include [[fever]], [[weakness]], [[pallor]], [[jaundice]], and [[perspiration]].  Other findings on physical exam are [[tachycardia]], [[tachypnea]], [[splenomegaly]], and [[hepatomegaly]].
 ==Physical Examination==
 ===Appearance of the Patient===
+The appearance of the patient depends on the stage of the disease.  The patient may be ill-looking, [[shivering]], and/or [[sweating]].  After the fever episode, patients appear extremely tired and sleepy. In more severe cases of the disease, the patient may appear [[anemic]], with [[jaundice]], or even in [[coma]].<ref name=CDC>{{cite web | title = Malaria | url = http://www.cdc.gov/malaria/about/disease.html }}</ref>
 ===Vitals===
 ====Temperature====
-*A [[fever]] is often present, according to the patterns described above
+*A [[fever]] is often present
 ====Pulse====
 =====Rate=====
 *[[Tachycardia]] may be present
-<!--
-=====Rhythm=====
-*The pulse is regular
-*The pules is irregularly irregular
-=====Strength=====
-*The pulse may be weak
-*The pulse may be bounding
-*The pulse may be alternating in strength ([[pulsus alternans]])
-*A [[paradoxical pulse]] may be present
-=====Symmetry=====
-*The pulses may be asymmetric
 ====Blood Pressure====
-*[[Hypotension]] may be present
+*[[Hypotension]] may be present (in severe cases of the disease)
-*[[Hypertension]] may be present
-*A [[wide pulse pressure]] may be present
-*A [[narrow pulse pressure]] may be present
 ====Respiratory Rate====
 *[[Tachypnea]] may be present
-*[[Bradypnea]] may be present
-* [[Kussmaul respirations]] may be present
 ===Skin===
-*[[Cyanosis]] may be present
+*[[Cyanosis]] may be present (in severe cases of the disease, where there may be [[respiratory distress]])
-*[[Jaundice]] may be present
+*[[Jaundice]] may be present (in severe [[anemia]])
-* A rash may be present
+*[[Pallor]] may be present
-* [[Pallor]] may be present
+*[[Petechiae]] may be present (in severe cases of the disease, when there is [[thrombocytopenia]])
-* Lesions may be present
-===Head===
-* Abnormalities of the head/hair may include ___
-* There may be evidence of trauma
 ===Eyes===
-*Icteric sclera may be present
+*Icteric [[sclera]] may be present (in severe [[anemia]] with [[jaundice]])
-* [[Nystagmus]] may be present.
+*[[Conjunctiva]]e may be pale
-* Extra-ocular movements may be abnormal
-*Pupils may not react to light
-*Ophthalmoscopic exam may be abnormal with findings of ___
-===Ears===
-* Hearing acuity may be reduced
-*[[Weber test]] may be positive
-*[[Rinne test]] may be positive
-* There may be [[exudate]] from the ear canal
-* There may be [[tenderness]] on movement of the pinnae
 ===Nose===
-* Nares may be inflamed
+* Alar flare (in severe cases of the disease, where there may be [[respiratory distress]])
-* There may be [[epistaxis]]
-* There may be [[purulent]] exudate from the nares
-* There may be [[tenderness]] to percussion of the sinuses
-* The nares may be congested
 ===Throat===
-* The throat may be erythematous
+* The [[throat]] may be erythematous
-* There may be [[exudate]] in the throat
-* There may be [[petechiae]] seen in the throat
-* There may be tonsillar inflammation
-===Neck===
-*[[Jugular venous pressure]] may be elevated
-*[[Carotid bruits]] may be present
-*[[Lymph nodes]] may be present
-*[[Thyromegaly]] may be present
-*[[Hepatojugular reflux]] may be present
 ===Lungs===
-*[[Pulmonary edema]] and [[rales]] may be present
+*[[Pulmonary edema]] may be present
-*[[Wheezing]] may be present
+*Consolidation may be present with reduced [[breath sounds]] auscultated (rarely)
-*Consolidation may be present with reduced breath sounds auscultated
+*Intercostal retraction may be present (in severe cases of the disease, where there may be [[respiratory distress]])
-*[[Rales]] may be present
-*[[Egophony]] may be present
-* Chest movement may be assymetric
-===Heart===
-*A [[heave]] may be present
-*A [[thrill]] may be present
-*A [[friction rub]] may be pressent
-====Auscultation====
-*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
-*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
-*[[Heart sounds#Third heart sound S3|S3]]
-*[[Heart sounds#Fourth heart sound S4|S4]]
-*[[Heart sounds#Summation Gallop|Gallops]]
-*A [[systolic murmur]] best heard at the base may be present
-*A [[systolic murmur]] best heard at the apex may be present
-*A [[diastolic murmur]] may be present
 ===Abdomen===
 *[[Abdominal distention]] may be present
-*[[Abdominal tenderness]] may be present
-*[[Rebound tenderness]] may be present
-*An [[acute abdomen]] may be present
-*An abdominal mass may be present
-*Guarding may be present
 *[[Hepatomegaly]] may be present
 *[[Splenomegaly]] may be present
-*Genitourinary exam if relevant
+===Genitourinary===
+*[[Hematuria]] may be present (in severe [[hemolysis]])
 ===Extremities===
-*[[Clubbing]] may be present
+*[[Cyanosis]] may be present (in severe [[anemia]])
-*[[Cyanosis]] may be present
+*[[Edema]] may be present (in severe disease, where there may be [[renal failure]])
-*[[Edema]] may be present
 ===Neurologic===
-* Mental status may be altered
+* [[Coma]] may be present (in [[cerebral malaria]])
-* Glasgow coma scale is ___
+* [[Altered mental status|Mental status may be altered]]
-* Clonus may be present
+* [[Convulsions]] may occur
-* Hyperactive reflexes may be present
-* There are deficits in cranial nerves ___
--->
 ==References==
@@ Line 141: / Line 58: @@
 [[Category:Tropical disease]]
 [[Category:Deaths from malaria]]
-[[Category:Infectious disease]]
 [[Category:Disease]]
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