Histoplasmosis physical examination: Difference between revisions

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===Disseminated Histoplasmosis===
===Disseminated Histoplasmosis===
Patients with disseminated histoplasma infection have similar features as sepsis. The following physical examination findings can be demonstrated in a patient with disseminated infection:
Patients with disseminated histoplasma infection have similar features as sepsis. The following physical examination findings can be demonstrated in a patient with disseminated infection:
 
====Vital Signs====
===Vital Signs===
* [[Hypotension]]
* [[Hypotension]]
Sepsis is considered present if infection is highly suspected or proven and two or more of the following [[systemic inflammatory response syndrome]] (SIRS) criteria are met:<ref name="pmid18158437">{{cite journal |author=Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL |title=Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008 |journal=[[Critical Care Medicine]] |volume=36 |issue=1 |pages=296–327 |year=2008 |month=January |pmid=18158437 |doi=10.1097/01.CCM.0000298158.12101.41 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=36&issue=1&spage=296 |accessdate=2012-09-16}}</ref><ref>Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.</ref>
Sepsis is considered present if infection is highly suspected or proven and two or more of the following [[systemic inflammatory response syndrome]] (SIRS) criteria are met:<ref name="pmid18158437">{{cite journal |author=Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL |title=Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008 |journal=[[Critical Care Medicine]] |volume=36 |issue=1 |pages=296–327 |year=2008 |month=January |pmid=18158437 |doi=10.1097/01.CCM.0000298158.12101.41 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=36&issue=1&spage=296 |accessdate=2012-09-16}}</ref><ref>Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.</ref>
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* [[Temperature]] < 36 (96.8 °F) or > 38 °C (100.4 °F)
* [[Temperature]] < 36 (96.8 °F) or > 38 °C (100.4 °F)
* [[Tachypnea]] > 20 breaths per minute or, on [[blood gas]], a P<sub>a</sub>CO<sub>2</sub> < 32 mm Hg
* [[Tachypnea]] > 20 breaths per minute or, on [[blood gas]], a P<sub>a</sub>CO<sub>2</sub> < 32 mm Hg
===Skin===
====Skin====
*[[Cyanosis]]
*[[Cyanosis]]
===HEENT===
====HEENT====
*Cervical [[Lymphadenopathy]]
*Cervical [[Lymphadenopathy]]
===Extremities===
====Extremities====
*Decreased peripheral [[pulse]]s
*Decreased peripheral [[pulse]]s
===Neurologic===
====Neurologic====
*Altered sensorium, lethargy, and [[coma]]
*Altered sensorium, lethargy, and [[coma]]


Revision as of 15:36, 4 May 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.

Overview

Physical Examination

Physical examination findings vary in patients with histoplasma infection and it depends on stage of the disease and extent of the spread of infection. Patients with acute or chronic pulmonary histoplasmosis present with features similar to pneumonia. The following physical examination findings can be demonstrated:

Lungs

Palpation

  • Increased tactile fremitus

Percussion

  • Dullness on percussion

Auscultation

Disseminated Histoplasmosis

Patients with disseminated histoplasma infection have similar features as sepsis. The following physical examination findings can be demonstrated in a patient with disseminated infection:

Vital Signs

Sepsis is considered present if infection is highly suspected or proven and two or more of the following systemic inflammatory response syndrome (SIRS) criteria are met:[1][2]

Skin

HEENT

Extremities

Neurologic

  • Altered sensorium, lethargy, and coma

Gallery

  • Skin lesion on the upper lip due to Histoplasma capsulatum infection.

    Skin lesion on the upper lip due to Histoplasma capsulatum infection.

  • Interior view of an elderly man’s oral cavity. A histoplasmosis infection induced inflammatory response on right inferior gingival tissues. From Public Health Image Library (PHIL). [3]

    Interior view of an elderly man’s oral cavity. A histoplasmosis infection induced inflammatory response on right inferior gingival tissues. From Public Health Image Library (PHIL). [3]

  • This image depicts the perianal region of a male patient afflicted with a disease known as histoplasmosis, which is caused by the fungal organism, Histoplasma capsulatum. From Public Health Image Library (PHIL). [3]

    This image depicts the perianal region of a male patient afflicted with a disease known as histoplasmosis, which is caused by the fungal organism, Histoplasma capsulatum. From Public Health Image Library (PHIL). [3]

  • This image depicts an intraoral view, which reveals a lesion of the patient’s maxillary gingival mucosa that had been diagnosed as histoplasmosis, caused by the fungal pathogen, Histoplasma capsulatum. From Public Health Image Library (PHIL). [3]

    This image depicts an intraoral view, which reveals a lesion of the patient’s maxillary gingival mucosa that had been diagnosed as histoplasmosis, caused by the fungal pathogen, Histoplasma capsulatum. From Public Health Image Library (PHIL). [3]

References

  1. ↑ Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Critical Care Medicine. 36 (1): 296–327. doi:10.1097/01.CCM.0000298158.12101.41. PMID 18158437. Retrieved 2012-09-16. Unknown parameter |month= ignored (help)
  2. ↑ Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.
  3. ↑ 3.0 3.1 3.2 "Public Health Image Library (PHIL)".
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