Marburg hemorrhagic fever physical examination: Difference between revisions

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{{Marburg hemorrhagic fever}}
{{Marburg hemorrhagic fever}}
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==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==
===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="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===
* 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===
[[Bleeding|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]]
 
* [[Epistaxis]]
* [[Nasal discharge]]
 
* [[Mucosal]] [[hyperemia]] of the [[oral cavity]]
* [[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===
* [[Abdominal tenderness]] (may suggest [[pancreatitis]], [[Intestine|intestinal]] [[swelling]], or [[Mesentery|mesenteric]] [[lymphadenopathy]])
* [[Abdominal distention]] (may suggest [[paralytic ileus]])
*[[Tenderness (medicine)|Tender]] [[hepatomegaly]]
*[[Splenomegaly]]
 
===Extremities===
* [[Edema]] may be present
 
===Neurologic===
* [[Obtundation]] may be present
*[[Stupor]]
*[[Coma]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Disease]]
[[Category:Disease]]

Latest revision as of 11:28, 23 October 2017

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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)

Skin

Hemorrhagic manifestations tend to occur during the more severe stages of the disease and may include:

HEENT

Lungs

  • Tachypnea (often precedes death during final hours of infection)

Abdomen

Extremities

Neurologic

References

  1. 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.