Cytomegalovirus infection physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic. On [[fundus]] examination fluffy yellow-white retinal lesions, with or without intraretinal [[hemorrhages]] can be demonstrated in patients with [[CMV]] [[retinitis]]. [[Abdominal distension]] and [[tenderness]] can be present on examination in patients with [[CMV colitis]]. In patients with [[CMV]] [[encephalitis]] [[altered mental status]] and focal neurological deficits are present. | |||
==Physical Examination== | ==Physical Examination== | ||
===General Appearance | ===General Appearance=== | ||
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic. | The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.<ref name="pmid28095374">{{cite journal| author=Zedtwitz-Liebenstein K, Diab-Elschahaw M, Frass M| title=Human Cytomegalovirus Infection in Nonimmunocompromised Patients: A Retrospective Analysis and Review of the Literature. | journal=Intervirology | year= 2016 | volume= 59 | issue= 3 | pages= 159-162 | pmid=28095374 | doi=10.1159/000454772 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28095374 }} </ref> | ||
===Vitals=== | ===Vitals=== | ||
=====Temperature===== | =====Temperature===== | ||
*[[Fever]] | *[[Fever]] | ||
=====Pulse===== | =====Pulse===== | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
=====Blood pressure===== | =====Blood pressure===== | ||
*[[Hypotension]] | *[[Hypotension]] | ||
==== Respiratory rate ==== | |||
*[[Tachypnea]] | |||
===HEENT=== | ===HEENT=== | ||
'''Eyes'''<br> | |||
On fundus examination the following findings can be demonstrated in patients with [[CMV]] [[retinitis]]: | |||
*Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage. | |||
*[[Inflammation]] of the [[vitreous]] can be demonstrated in patients with severe [[immunosuppression]]. | |||
* | *[[Blood vessels]] appear sheathed. | ||
*If left untreated, [[retinitis]] is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar. | |||
===Cardiovascular=== | ===Cardiovascular=== | ||
*Normal heart sounds | *Normal [[heart sounds]] | ||
*No [[murmurs]], gallops or rubs | *No [[murmurs]], gallops or rubs | ||
===Lungs=== | ===Lungs=== | ||
*[[Crackles]] and [[rhonchi]] may be | *[[Crackles]] and [[rhonchi]] may be heard in patients with [[CMV]] [[pneumonitis]].<ref name="pmid27547053">{{cite journal| author=Luscalov S, Loga L, Dican L, Junie LM| title=Cytomegalovirus infection in immunosuppressed patients after kidney transplantation. | journal=Clujul Med | year= 2016 | volume= 89 | issue= 3 | pages= 343-6 | pmid=27547053 | doi=10.15386/cjmed-587 | pmc=4990428 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27547053 }} </ref> | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal tenderness]] | *[[Abdominal tenderness]] | ||
*Abdominal distension | *[[Abdominal distension]] can be present on examination in patients with [[CMV]] [[colitis]].<ref name="pmid27460032">{{cite journal| author=Khan TV, Toms C| title=Cytomegalovirus Colitis and Subsequent New Diagnosis of Inflammatory Bowel Disease in an Immunocompetent Host: A Case Study and Literature Review. | journal=Am J Case Rep | year= 2016 | volume= 17 | issue= | pages= 538-43 | pmid=27460032 | doi= | pmc=4968430 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27460032 }} </ref> | ||
=== | |||
===Central Nervous System=== | ===Central Nervous System=== | ||
The following examination findings can be present in [[CMV]] [[encephalitis]]: | |||
*Focal neurological deficits | *Focal neurological deficits | ||
*[[Altered mental status]] | *[[Altered mental status]] | ||
*[[Hypotonia]] | *[[Hypotonia]] | ||
*Normal or diminished deep [[tendon]] [[reflexes]] | *Normal or diminished deep [[tendon]] [[reflexes]] | ||
==References== | |||
{{Reflist|2}} | |||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Neurology]] | |||
[[Category:Neurosurgery]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Ophthalmology]] | |||
Latest revision as of 21:13, 29 July 2020
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Cytomegalovirus infection Microchapters |
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Differentiating Cytomegalovirus infection from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Cytomegalovirus infection physical examination On the Web |
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American Roentgen Ray Society Images of Cytomegalovirus infection physical examination |
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Risk calculators and risk factors for Cytomegalovirus infection physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic. On fundus examination fluffy yellow-white retinal lesions, with or without intraretinal hemorrhages can be demonstrated in patients with CMV retinitis. Abdominal distension and tenderness can be present on examination in patients with CMV colitis. In patients with CMV encephalitis altered mental status and focal neurological deficits are present.
Physical Examination
General Appearance
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.[1]
Vitals
Temperature
Pulse
Blood pressure
Respiratory rate
HEENT
Eyes
On fundus examination the following findings can be demonstrated in patients with CMV retinitis:
- Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
- Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
- Blood vessels appear sheathed.
- If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.
Cardiovascular
- Normal heart sounds
- No murmurs, gallops or rubs
Lungs
- Crackles and rhonchi may be heard in patients with CMV pneumonitis.[2]
Abdomen
- Abdominal tenderness
- Abdominal distension can be present on examination in patients with CMV colitis.[3]
Central Nervous System
The following examination findings can be present in CMV encephalitis:
- Focal neurological deficits
- Altered mental status
- Hypotonia
- Normal or diminished deep tendon reflexes
References
- ↑ Zedtwitz-Liebenstein K, Diab-Elschahaw M, Frass M (2016). "Human Cytomegalovirus Infection in Nonimmunocompromised Patients: A Retrospective Analysis and Review of the Literature". Intervirology. 59 (3): 159–162. doi:10.1159/000454772. PMID 28095374.
- ↑ Luscalov S, Loga L, Dican L, Junie LM (2016). "Cytomegalovirus infection in immunosuppressed patients after kidney transplantation". Clujul Med. 89 (3): 343–6. doi:10.15386/cjmed-587. PMC 4990428. PMID 27547053.
- ↑ Khan TV, Toms C (2016). "Cytomegalovirus Colitis and Subsequent New Diagnosis of Inflammatory Bowel Disease in an Immunocompetent Host: A Case Study and Literature Review". Am J Case Rep. 17: 538–43. PMC 4968430. PMID 27460032.