West nile virus physical examination: Difference between revisions

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{{West nile virus}}
{{West nile virus}}
{{CMG}}
{{CMG}}
{{MJM}}


==Overview==
==Overview==
An estimated 70-80% of human WNV infections are subclinical or asymptomatic. Most symptomatic persons experience an acute systemic febrile illness that often includes headache, weakness, myalgia, or arthralgia; gastrointestinal symptoms and a transient maculopapular rash also are commonly reported.
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==
==Physical exam==
It is possible for a patient with West nile virus to present with signs of [[encephalitis]] and [[meningoencephalitis]]. These signs include:
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>


*[[Stupor]]
===Vital signs===
*[[Coma]]
* [[Fever]]
*[[Confusion]]
* [[Tachycardia]]
* [[Tachypnea]]


Other clinical findings can include things such as:
===Skin===
* [[Macular]] or [[papular]] truncal [[rash]]


*[[Papilledema]]
===HEENT===
*[[Cranial nerve]] involvement
* [[Papilledema]]
*Decreased [[sensation]]
* [[Nystagmus]]
*[[hyperreflexia]]
* [[Lymphadenopathy]]
*Positive [[Brudzinki signs]] and [[Kernig signs]]
* Non exudative [[pharyngeal erythema]]
*Motor strength weakness
 
===Chest===
*Ataxic or apneustic breathing
 
===Abdomen===
* [[Abdominal tenderness]]
* [[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==
==References==
{{Reflist|2}}
{{Reflist|2}}

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

HEENT

Chest

  • Ataxic or apneustic breathing

Abdomen

Neurologic

References

  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
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