Malaria physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Physical Examination

Appearance of the Patient

Depending on the stage of the disease the patient may appear ill, nauseated, shivering; or febrile, with headaches; or may appear fatigued and sleepy.

Vitals

Temperature

• A fever is often present, according to the patterns described above

Pulse

Rate

• Tachycardia may be present

Blood Pressure

• Hypotension may be present (in severe cases of the disease)

Respiratory Rate

• Tachypnea may be present

Skin

• Cyanosis may be present (in severe cases of the disease, where there may be respiratory distress)
• Jaundice may be present (in severe anemia)
• Pallor may be present
• Petechiae may be present (in severe cases of the disease, when there is thrombocytopenia)

Eyes

• Icteric sclera may be present (in severe anemia with jaundice)
• Conjunctivae may be pale

Nose

• Alar flare (in severe cases of the disease, where there may be respiratory distress)

Throat

• The throat may be erythematous

Lungs

• Pulmonary edema may be present
• Consolidation may be present with reduced breath sounds auscultated
• Intercostal retraction may be present (in severe cases of the disease, where there may be respiratory distress)

Abdomen

• Abdominal distention may be present
• An abdominal mass may be present
• Hepatomegaly may be present
• Splenomegaly may be present

Genitourinary

• Hematuria may be present (in severe hemolysis)

Extremities

• Cyanosis may be present (in severe anemia)
• Edema may be present (in severe disease, where there may be renal failure)

Neurologic

• Coma may be present (in cerebral malaria)
• Mental status may be altered
• Convulsions may be present