Blastomycosis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are lungs, skin, bones, genitourinary system, central nervous system and other organs. | The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are [[lungs]], [[skin]], [[bones]], [[genitourinary system]], [[central nervous system]] and other organs. | ||
==Physical Examination== | ==Physical Examination== | ||
| Line 13: | Line 13: | ||
===Oral cavity=== | ===Oral cavity=== | ||
*[[Oral ulcers]] can be seen in some patients | *[[Oral ulcers]] can be seen in some patients | ||
=== | ===Lymph nodes=== | ||
*In cases with [[skin]] involvement from direct [[inoculation]], regiona[[Lymphadenopathy|l lymph node enlargement]] may be seen. | |||
===Neck=== | |||
*No masses | |||
===Cardiovascular system=== | |||
*Regular rate and rhythm | |||
*[[Heart sounds|Normal S1, S2]] | |||
*No [[murmurs]], rubs, or [[Gallops and Extra Heart Sounds|gallops]] | |||
===Lungs=== | ===Lungs=== | ||
Findings consistent with [[Consolidation (medicine)|parenchymal consolidation]] such as<ref>{{cite book | last = Kauffman | first = Carol | title = Essentials of clinical mycology | publisher = Springer | location = New York | year = 2011 | isbn = 978-1-4419-6639-1 }}</ref> | Findings consistent with [[Consolidation (medicine)|parenchymal consolidation]] such as<ref>{{cite book | last = Kauffman | first = Carol | title = Essentials of clinical mycology | publisher = Springer | location = New York | year = 2011 | isbn = 978-1-4419-6639-1 }}</ref> | ||
*[[Percussion of the lungs|Dullness to percussion]] | *[[Percussion of the lungs|Dullness to percussion]] | ||
*Increased [[fremitus]] | *Increased [[fremitus]] | ||
*Signs of pleura involvement such as pleuritic rub. | *Signs of [[pleura]] involvement such as [[pleuritic]] rub. | ||
===Abdominal=== | |||
*[[Abdomen]] soft and non-distended with no [[scars]] or striations | |||
*No pulsatile [[Mass|masses]] or [[Abdominal bruit|abdominal bruits]] ascultated | |||
*[[Spleen]] not palpable, [[liver]] not palpable | |||
===Skin=== | ===Skin=== | ||
*Ulcerative lesions that bleed easily | *Ulcerative lesions that bleed easily | ||
*Verrucous lesions with irregular border and variegated appearance | *Verrucous lesions with irregular border and variegated appearance | ||
===Bone and joints=== | ===Bone and joints=== | ||
*Soft tissue swelling around the area of involvement and discharging sinuses might be consistent with [[osteomyelitis]]. | *[[Soft tissue]] [[swelling]] around the area of involvement and discharging [[sinuses]] might be consistent with [[osteomyelitis]]. | ||
*[[Arthritis]] can cause reproducible pain in joints. | *[[Arthritis]] can cause reproducible [[pain]] in [[joints]]. | ||
===Genitourinary system=== | ===Genitourinary system=== | ||
| Line 56: | Line 47: | ||
===Extremities=== | ===Extremities=== | ||
*Ulcers | *[[Ulcers]] that bleed on touch | ||
===Neurological=== | |||
Normal examination finding unless the infection is disseminated to brain resulting in meningitis,then findings include : | |||
*[[Consciousness|Altered level of consciousness]] | |||
*[[Nuchal rigidity]] | |||
=====Gallery===== | =====Gallery===== | ||
<gallery> | <gallery> | ||
Image: | Image: Blastomycosis08.jpeg| Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | ||
Image: Blastomycosis09.jpeg| Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: | Image: Blastomycosis11.jpeg|Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, which was caused by Blastomyces dermatitidis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | ||
Image: Blastomycosis13.jpeg| Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Blastomycosis15.jpeg|Patient’s right ankle displayed keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
</gallery> | </gallery> | ||
| Line 70: | Line 72: | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Latest revision as of 20:37, 29 July 2020
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Blastomycosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Blastomycosis physical examination On the Web |
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American Roentgen Ray Society Images of Blastomycosis physical examination |
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Risk calculators and risk factors for Blastomycosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2], Vidit Bhargava, M.B.B.S [3]
Overview
The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are lungs, skin, bones, genitourinary system, central nervous system and other organs.
Physical Examination
Vital Signs
Oral cavity
- Oral ulcers can be seen in some patients
Lymph nodes
- In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.
Neck
- No masses
Cardiovascular system
- Regular rate and rhythm
- Normal S1, S2
- No murmurs, rubs, or gallops
Lungs
Findings consistent with parenchymal consolidation such as[2]
- Dullness to percussion
- Increased fremitus
- Signs of pleura involvement such as pleuritic rub.
Abdominal
- Abdomen soft and non-distended with no scars or striations
- No pulsatile masses or abdominal bruits ascultated
- Spleen not palpable, liver not palpable
Skin
- Ulcerative lesions that bleed easily
- Verrucous lesions with irregular border and variegated appearance
Bone and joints
- Soft tissue swelling around the area of involvement and discharging sinuses might be consistent with osteomyelitis.
- Arthritis can cause reproducible pain in joints.
Genitourinary system
Extremities
- Ulcers that bleed on touch
Neurological
Normal examination finding unless the infection is disseminated to brain resulting in meningitis,then findings include :
Gallery
-
![Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/images/b/ba/Blastomycosis08.jpeg)
Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]
-
![Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/images/1/17/Blastomycosis09.jpeg)
Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]
-
![Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, which was caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/images/e/e4/Blastomycosis11.jpeg)
Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, which was caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]
-
![Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/images/7/7e/Blastomycosis13.jpeg)
Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]
-
![Patient’s right ankle displayed keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/images/e/e8/Blastomycosis15.jpeg)
Patient’s right ankle displayed keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]
![Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/index.php/File:Blastomycosis08.jpeg)
![Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/index.php/File:Blastomycosis09.jpeg)
![Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, which was caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/index.php/File:Blastomycosis11.jpeg)
![Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/index.php/File:Blastomycosis13.jpeg)
![Patient’s right ankle displayed keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). [3]](/index.php/File:Blastomycosis15.jpeg)
References
- ↑ Smith JA, Gauthier G (2015). "New Developments in Blastomycosis". Semin Respir Crit Care Med. 36 (5): 715–28. doi:10.1055/s-0035-1562898. PMID 26398538.
- ↑ Kauffman, Carol (2011). Essentials of clinical mycology. New York: Springer. ISBN 978-1-4419-6639-1.
- ↑ 3.0 3.1 3.2 3.3 3.4 "Public Health Image Library (PHIL)".