Marburg hemorrhagic fever physical examination: Difference between revisions
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{{Marburg hemorrhagic fever}} | {{Marburg hemorrhagic fever}} | ||
{{CMG}}{{AE}} | |||
{{CMG}}{{AE}}{{Anmol}} | |||
==Overview== | ==Overview== | ||
Marburg hemorrhagic fever is commonly associated with [[fever]] on physical examination at admission. At advanced stages of the disease, physical examination findings are more pertinent and often include unstable vital signs, such as [[tachycardia]] or [[relative bradycardia]], orthostatic [[hypotension]], and [[tachypnea]]. Physical examination may also be remarkable for [[abdominal tenderness]] and [[Abdominal distension|distension]], evidence of [[mucosal]] or [[visceral]] [[bleeding]], and neurological impairment. | |||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
The general appearance of the patient depends on the stage of the disease. Typically, patients demonstrate [[prostration]], may be [[nauseated]] and [[vomiting]], and less commonly present with signs of hemorrhage, such as epistaxis or gingival bleeding. In later stages of the disease, patients are often brought with convulsions or are in a state of shock, stupor, or coma.<ref name=" | The general appearance of the patient depends on the stage of the disease. Typically, patients demonstrate [[prostration]], may be [[nauseated]] and [[vomiting]], and less commonly present with signs of [[hemorrhage]], such as [[epistaxis]] or [[gingival bleeding]]. In later stages of the disease, patients are often brought with [[convulsions]] or are in a state of [[shock]], [[stupor]], or [[coma]].<ref name="pmid22046196">{{cite journal |vauthors=Mehedi M, Groseth A, Feldmann H, Ebihara H |title=Clinical aspects of Marburg hemorrhagic fever |journal=Future Virol |volume=6 |issue=9 |pages=1091–1106 |year=2011 |pmid=22046196 |pmc=3201746 |doi=10.2217/fvl.11.79 |url=}}</ref> | ||
===Vitals=== | ===Vitals=== | ||
* High-grade [[fever]] (most common presenting sign) | |||
* High-grade [[fever]] | |||
*[[Tachycardia]] | *[[Tachycardia]] | ||
* Relative [[bradycardia]] | * Relative [[bradycardia]] | ||
* [[Hypotension]] (SBP<90 mmHg and/or DBP<60 mmHg) | * [[Hypotension]] (SBP<90 mmHg and/or DBP<60 mmHg) | ||
* [[Postural hypotension]] | * [[Postural hypotension]] (common in dehydrated patients with inadequate volume repletion) | ||
===Skin=== | ===Skin=== | ||
[[Bleeding|Hemorrhagic]] manifestations tend to occur during the more severe stages of the disease and may include: | [[Bleeding|Hemorrhagic]] manifestations tend to occur during the more severe stages of the disease and may include: | ||
:* [[Maculopapular rash]] on the [[trunk]] | :* [[Maculopapular rash]] on the [[trunk]] | ||
:* [[Petechiae]] | :* [[Petechiae]] | ||
:* [[Ecchymoses]] | :* [[Ecchymoses]] | ||
:* [[Mucosal]] [[hemorrhages]] | :* [[Mucosal]] [[hemorrhages]] | ||
:* Uncontrolled [[bleeding]] from [[venipuncture]] | :* Uncontrolled [[bleeding]] from [[venipuncture]] sites | ||
=== | ===HEENT=== | ||
* [[Conjunctival hemorrhage]] | * [[Conjunctival hemorrhage]] (most common sign of abnormal clotting) | ||
* [[Conjunctivitis]] | * [[Conjunctivitis]] | ||
* [[Epistaxis]] | |||
* [[Epistaxis]] | * [[Nasal discharge]] | ||
* [[Nasal discharge]] | |||
* [[Mucosal]] [[hyperemia]] of the [[oral cavity]] | |||
* [[Mucosal]] [[hyperemia]] of the [[oral cavity]] | * [[Bleeding gums]] | ||
* [[Bleeding gums]] | |||
===Lungs=== | |||
*[[Signs]] of [[shortness of breath|respiratory difficulty]] may be present, such as: | |||
:* [[Intercostal]] retractions | |||
:* Paradoxical [[breathing]] | |||
:* [[Nasal]] flare | |||
*[[Tachypnea]] (often precedes death during final hours of infection) | |||
===Abdomen=== | ===Abdomen=== | ||
* [[Abdominal tenderness]] may suggest [[pancreatitis]], [[intestinal swelling]], or [[mesenteric lymphadenopathy]] | * [[Abdominal tenderness]] (may suggest [[pancreatitis]], [[Intestine|intestinal]] [[swelling]], or [[Mesentery|mesenteric]] [[lymphadenopathy]]) | ||
* [[Abdominal distention]] may suggest [[paralytic ileus]] | * [[Abdominal distention]] (may suggest [[paralytic ileus]]) | ||
*Tender hepatomegaly | *[[Tenderness (medicine)|Tender]] [[hepatomegaly]] | ||
*Splenomegaly | *[[Splenomegaly]] | ||
===Extremities=== | ===Extremities=== | ||
* [[Edema]] may be present | * [[Edema]] may be present | ||
===Neurologic=== | ===Neurologic=== | ||
* [[Obtundation]] may be present | * [[Obtundation]] may be present | ||
*[[Stupor]] | *[[Stupor]] | ||
*[[Coma]] | *[[Coma]] | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 11:28, 23 October 2017
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Marburg hemorrhagic fever Microchapters |
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Differentiating Marburg hemorrhagic fever from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Marburg hemorrhagic fever physical examination On the Web |
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American Roentgen Ray Society Images of Marburg hemorrhagic fever physical examination |
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Risk calculators and risk factors for Marburg hemorrhagic fever physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
Marburg hemorrhagic fever is commonly associated with fever on physical examination at admission. At advanced stages of the disease, physical examination findings are more pertinent and often include unstable vital signs, such as tachycardia or relative bradycardia, orthostatic hypotension, and tachypnea. Physical examination may also be remarkable for abdominal tenderness and distension, evidence of mucosal or visceral bleeding, and neurological impairment.
Physical Examination
Appearance of the Patient
The general appearance of the patient depends on the stage of the disease. Typically, patients demonstrate prostration, may be nauseated and vomiting, and less commonly present with signs of hemorrhage, such as epistaxis or gingival bleeding. In later stages of the disease, patients are often brought with convulsions or are in a state of shock, stupor, or coma.[1]
Vitals
- High-grade fever (most common presenting sign)
- Tachycardia
- Relative bradycardia
- Hypotension (SBP<90 mmHg and/or DBP<60 mmHg)
- Postural hypotension (common in dehydrated patients with inadequate volume repletion)
Skin
Hemorrhagic manifestations tend to occur during the more severe stages of the disease and may include:
- Maculopapular rash on the trunk
- Petechiae
- Ecchymoses
- Mucosal hemorrhages
- Uncontrolled bleeding from venipuncture sites
HEENT
- Conjunctival hemorrhage (most common sign of abnormal clotting)
- Conjunctivitis
- Mucosal hyperemia of the oral cavity
- Bleeding gums
Lungs
- Signs of respiratory difficulty may be present, such as:
- Intercostal retractions
- Paradoxical breathing
- Nasal flare
- Tachypnea (often precedes death during final hours of infection)
Abdomen
- Abdominal tenderness (may suggest pancreatitis, intestinal swelling, or mesenteric lymphadenopathy)
- Abdominal distention (may suggest paralytic ileus)
- Tender hepatomegaly
- Splenomegaly
Extremities
- Edema may be present
Neurologic
- Obtundation may be present
- Stupor
- Coma
References
- ↑ Mehedi M, Groseth A, Feldmann H, Ebihara H (2011). "Clinical aspects of Marburg hemorrhagic fever". Future Virol. 6 (9): 1091–1106. doi:10.2217/fvl.11.79. PMC 3201746. PMID 22046196.