Brucellosis physical examination: Difference between revisions

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__NOTOC__
{{CMG}}; {{AE}} {{RT}} {{DL}}{{VD}}
{{Brucellosis}}
{{CMG}}; {{AE}} {{RT}} {{DL}}
 
==Overview==
==Overview==
Patients with brucellosis are usually well-appearing. Physical examination findings usually reveal combination of  several non-specific findings.  
Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of  several non-specific findings.
 
==Physical Examination==
==Physical Examination==
Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:<ref>Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.</ref><ref>Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.</ref><ref>Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.</ref><ref>Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.</ref><ref>Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.</ref><ref>Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.</ref><ref>Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.</ref><ref>Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.</ref><ref>Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.</ref><ref>Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.</ref>
Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:<ref>Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.</ref><ref>Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.</ref><ref>Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.</ref><ref>Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.</ref><ref>Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.</ref><ref>Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.</ref><ref>Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.</ref><ref>Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.</ref><ref>Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.</ref><ref>Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.</ref>
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|-
|-
|Vital Signs
|Vital Signs
|Pulse rate-Normal/[[Tachycardia]] with regular rhythm, normal volume
|[[Pulse rate]]-Normal/[[Tachycardia]] with regular rhythm, normal volume
Temperature- Normal or elevated
[[Temperature]]- Normal or elevated


Blood pressure- Normal
[[Blood pressure]]- Normal


Respiratory rate-Normal/tachypnea(pneumonia/lung involvement)
[[Respiratory rate]]-Normal/[[tachypnea]](pneumonia/lung involvement)


[[Oxygen saturation]]- usually normal but some cases may have low oxygen saturation(lung involvement).
[[Oxygen saturation]]- usually normal but some cases may have low oxygen saturation(lung involvement).


Blood glucose level- normal
[[Blood glucose|Blood glucoselevel]]- normal
|-
|-
|[[Skin]]
|[[Skin]]
|Skin examination may reveal the following:
|Skin examination may be normal or reveal the following:
* Maculppapular rash
*[[Maculopapular rash]]
* Erythema nodosum like eruptions and ulceration
*[[Erythema nodosum]] like eruptions and ulceration
* abscesses
*[[Abscesses]]
|-
|-
|HEENT
|HEENT
|Eye examination is usually normal but signs of [[Uveitis]] may be elicit in few patients  
|Eye examination is usually normal but signs of [[Uveitis]] may be elicit in few patients
|-
|-
|Neck
|Neck
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|-
|-
|[[Lungs]]
|[[Lungs]]
|Brucellosis involving lung, may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
|Brucellosis involving [[lung]], may reveal multiple findings depending on the kind of involvement(it could be [[pneumonia]], [[bronchitis]], [[pleural effusion]] or [[empyema]] or combination of these). Based on the involvement, lung examination may reveal:
*Increased [[tactile fremitus]]
*Increased [[tactile fremitus]]
*Dullness on [[Percussion of the lungs|percussion]]
*Dullness on [[Percussion of the lungs|percussion]]
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|-
|-
|[[Heart]]
|[[Heart]]
|Brucellosis involving heart may reveal murmurs on ascultation(endocarditis)
|Heart examination may reveal [[murmurs]] on ascultation(endocarditis)
|-
|-
|[[Abdomen]]
|[[Abdomen]]
|Abdominal examination may elicit:
|Abdominal examination may elicit:
* Tenderness
*Tenderness


*[[Hepatomegaly]]
*[[Hepatomegaly]]
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|-
|-
|[[Neuromuscular]]
|[[Neuromuscular]]
|Meningial signs of irritation  [[Nuchal rigidity]], [[Kernig's sign]], and [[Brudzinski's sign]] can be ilicited in cases with neurological involvement(meningitis or meningoencephalitis).
|Meningial signs of irritation  [[Nuchal rigidity]], [[Kernig's sign]], and [[Brudzinski's sign]] can be ilicited in cases with neurological involvement([[meningitis]] or [[meningoencephalitis]]).
 
Signs of neuropathies involving individual pheripheral nerve or cranial nerve can be ilicited
Signs of neuropathies involving individual pheripheral nerve or cranial nerve can be ilicited
|}
|}
*
*
==Reference==
{{reflist|2}}__NOTOC__
{{Brucellosis}}


==Reference==
{{reflist|2}}
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Occupational diseases]]
[[Category:Occupational diseases]]

Revision as of 20:24, 9 January 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza LukacVishal Devarkonda, M.B.B.S[3]

Overview

Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings.

Physical Examination

Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:[1][2][3][4][5][6][7][8][9][10]

Examination findings Brucellosis
Appearance of patient Patients are usually well-appearing
Vital Signs Pulse rate-Normal/Tachycardia with regular rhythm, normal volume

Temperature- Normal or elevated

Blood pressure- Normal

Respiratory rate-Normal/tachypnea(pneumonia/lung involvement)

Oxygen saturation- usually normal but some cases may have low oxygen saturation(lung involvement).

Blood glucoselevel- normal

Skin Skin examination may be normal or reveal the following:
HEENT Eye examination is usually normal but signs of Uveitis may be elicit in few patients
Neck Neck examination is usually normal but cervical lymphadenopathy may be present in few patients
Lungs Brucellosis involving lung, may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
Heart Heart examination may reveal murmurs on ascultation(endocarditis)
Abdomen Abdominal examination may elicit:
  • Tenderness
Back Back examination is usually normal
Genitourinary Genitourinary examination may reveal:
Extremities
  • Examination of Knee, hips, ankles and wrists may reveal:
    • Fluid around a joint
    • Warm, red, tender joints
    • Difficulty moving a joint (called "limited range of motion")
    • May be present in peripheral arthritis
  • palpation of sacroiliac joints may reveal pain indicating sacroiliitis
  • Positive Schober's test(indicative of spondylitis)
Neuromuscular Meningial signs of irritation Nuchal rigidity, Kernig's sign, and Brudzinski's sign can be ilicited in cases with neurological involvement(meningitis or meningoencephalitis).

Signs of neuropathies involving individual pheripheral nerve or cranial nerve can be ilicited

Reference

  1. ↑ Colmenero JD, Reguera JM, Martos F, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore) 1996; 75:195.
  2. ↑ Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol 2007; 25:188.
  3. ↑ Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352:2325.
  4. ↑ Doganay M, Aygen B. Human brucellosis: An overview. Int J Infect Dis 2003; 7:173.
  5. ↑ Young EJ. Brucellosis: current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 1995; 15:115.
  6. ↑ Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  7. ↑ Geyik MF, Gür A, Nas K, et al. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002; 132:98.
  8. ↑ Mousa AM, Bahar RH, Araj GF, et al. Neurological complications of brucella spondylitis. Acta Neurol Scand 1990; 81:16.
  9. ↑ Pappas G, Bosilkovski M, Akritidis N, et al. Brucellosis and the respiratory system. Clin Infect Dis 2003; 37:e95.
  10. ↑ Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.

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