Anthrax physical examination: Difference between revisions
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===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
The appearance of the patients and physical exam | The appearance of the patients and physical exam depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection).<ref name=CDC>{{cite web | title = Anthrax symptoms | url = http://www.cdc.gov/anthrax/basics/symptoms.html }}</ref><ref name=WHO>{{cite web | title = Anthrax in Humans and Animals | url = http://www.who.int/csr/resources/publications/anthrax_web.pdf }}</ref> | ||
===Vitals=== | ===Vitals=== | ||
====Temperature==== | ====Temperature==== | ||
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===Skin=== | ===Skin=== | ||
=====Cutaneous Anthrax===== | =====Cutaneous Anthrax===== | ||
* A [[rash]] is often present. | * A [[rash]] is often present. The rash initially appears as a small [[papule]] which then develops a ring of [[vesicles]] around the [[papule]], possibly with [[exudate]]. Between days 5 - 7, the initial [[papule]] ulcerates to form a typical [[scar]]. | ||
* [[Edema]] may be present | * [[Edema]] may be present | ||
* Regional [[lymphadenitis]] may be present | * Regional [[lymphadenitis]] may be present | ||
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===Throat=== | ===Throat=== | ||
=====Gastrointestinal Anthrax===== | =====Gastrointestinal Anthrax===== | ||
* The [[throat]] may be [[erythematous]] if lesion located on [[oropharyngeal]] mucosa | * The [[throat]] may be [[erythematous]] if the lesion is located on the [[oropharyngeal]] mucosa | ||
* [[Exudate]] may be present if lesion located on oropharyngeal mucosa | * [[Exudate]] may be present if the lesion is located on oropharyngeal mucosa | ||
* Tonsillar [[inflammation]] may be present if lesion located on [[oropharyngeal]] mucosa | * Tonsillar [[inflammation]] may be present if the lesion is located on [[oropharyngeal]] mucosa | ||
=====Inhalation Anthrax===== | =====Inhalation Anthrax===== | ||
* [[Edema]] may be present | * [[Edema]] may be present | ||
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===Abdomen=== | ===Abdomen=== | ||
=====Cutaneous Anthrax===== | =====Cutaneous Anthrax===== | ||
*[[Abdominal tenderness]] may be present, particularly if exuberant vomiting | *[[Abdominal tenderness]] may be present, particularly if there is exuberant vomiting | ||
=====Gastrointestinal Anthrax===== | =====Gastrointestinal Anthrax===== | ||
* [[Abdominal distention]] may be present | * [[Abdominal distention]] may be present | ||
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===Neurologic=== | ===Neurologic=== | ||
=====Cutaneous Anthrax===== | =====Cutaneous Anthrax===== | ||
* [[ | * The [[mental status]] may be altered in case of severe systemic anthrax | ||
=====Gastrointestinal Anthrax===== | =====Gastrointestinal Anthrax===== | ||
* [[ | * The [[mental status]] may be altered in case of severe systemic anthrax | ||
* [[Coma]] may be present | * [[Coma]] may be present | ||
=====Inhalation Anthrax===== | =====Inhalation Anthrax===== | ||
* [[ | * The [[mental status]] may be altered in case of severe systemic anthrax | ||
* [[Coma]] may be present | * [[Coma]] may be present | ||
Revision as of 19:31, 17 July 2014
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Anthrax Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Anthrax physical examination On the Web |
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American Roentgen Ray Society Images of Anthrax physical examination |
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Risk calculators and risk factors for Anthrax physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
The physical findings of anthrax infection depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection). Common findings associated with cutaneous anthrax infection include fever, tachycardia, skin rash with formation of a typical scar, edema and lymphadenopathy; with gastrointestinal anthrax infection include fever, tachycardia, mucosal ulcer and edema in case of oropharyngeal lesion and edema and pallor in more severe cases; with inhalation anthrax infection includes: fever, tachycardia, bradypnea in severe cases, pallor, cyanosis and decreased heart and lung sounds in the presence of pleural effusion; and with anthrax infection due to injection include fever, typical skin scar at the site of injection, edema and subcutaneous and/or muscular abscess.
Physical Examination
Appearance of the Patient
The appearance of the patients and physical exam depend on the mode of anthrax exposure in the patient (cutaneous, ingestion, inhalation, injection).[1][2]
Vitals
Temperature
Cutaneous Anthrax
- A fever is often present
Gastrointestinal Anthrax
- A fever is often present
Inhalation Anthrax
- A fever is often present
Injection Anthrax
- A fever is often present
Pulse
Rate
Cutaneous Anthrax
- Tachycardia is often present
Gastrointestinal Anthrax
- Tachycardia is often present
Inhalation or Pulmonary Anthrax
- Tachycardia is often present
Injection Anthrax
- Tachycardia is often present
Blood Pressure
Cutaneous Anthrax
- Hypotension may be present in severe systemic cases
Gastrointestinal Anthrax
- Hypotension may be present in severe systemic cases
Inhalation Anthrax
- Hypotension may be present in severe systemic cases
Respiratory Rate
Gastrointestinal Anthrax
- Bradypnea may be present in more severe cases
Inhalation Anthrax
- Bradypnea is often present
Skin
Cutaneous Anthrax
- A rash is often present. The rash initially appears as a small papule which then develops a ring of vesicles around the papule, possibly with exudate. Between days 5 - 7, the initial papule ulcerates to form a typical scar.
- Edema may be present
- Regional lymphadenitis may be present
Gastrointestinal Anthrax
- Edema may be present, particularly in the neck region
- Pallor may be present in cases of systemic anthrax with shock
Inhalation Anthrax
Throat
Gastrointestinal Anthrax
- The throat may be erythematous if the lesion is located on the oropharyngeal mucosa
- Exudate may be present if the lesion is located on oropharyngeal mucosa
- Tonsillar inflammation may be present if the lesion is located on oropharyngeal mucosa
Inhalation Anthrax
- Edema may be present
Neck
Cutaneous Anthrax
- Lymph nodes may be present, particularly if initial lesion is located in that region
Gastrointestinal Anthrax
- Painful lymph nodes may be present
- Edema may be present in oropharyngeal anthrax
Inhalation Anthrax
- Edema may be present
- Lymph nodes may be present
Auscultation
Inhalation Anthrax
- Heart and lung sounds may be decreased in the presence of pleural effusion
Abdomen
Cutaneous Anthrax
- Abdominal tenderness may be present, particularly if there is exuberant vomiting
Gastrointestinal Anthrax
- Abdominal distention may be present
- Abdominal tenderness may be present
Extremities
Cutaneous Anthrax
- Edema may be present, particularly around the initial lesion
Gastrointestinal Anthrax
- Edema may be present
Inhalation Anthrax
Neurologic
Cutaneous Anthrax
- The mental status may be altered in case of severe systemic anthrax
Gastrointestinal Anthrax
- The mental status may be altered in case of severe systemic anthrax
- Coma may be present
Inhalation Anthrax
- The mental status may be altered in case of severe systemic anthrax
- Coma may be present