Escherichia coli enteritis physical examination

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

Overview

Physical examination of patients with E. coli enteritis may be remarkable for abdominal tenderness, fever (occasionally), and signs of dehydration, such as abnormal orthostatic vital signs, reduced skin turgor, slow capillary refill, and dry mucous membranes. Physical examination among patients with severe dehydration may be remarkable for altered mental status. Physical examination may also be remarkable for findings suggestive of complications of the E. coli enteritis (e.g. hemolytic uremic syndrome), such as skin pallor, petechiae, and bruises.

Physical Examination

• Physical examination is generally remarkable for signs of dehydration.
• Physical examination, however, should also focus on findings that may be suggestive of development of E. coli enteritis-associated complications, such as hemolytic uremic syndrome.

General Appearance

• Ill-appearing
• Crying (in pediatric patients)

Vital Signs

• Fever (usually absent in EHEC-enteritis)
• Tachycardia
• Tachypnea
• Orthostatic hypotension may be suggestive of dehydration (due to diarrhea and/or vomiting)

Skin

• Reduced skin turgor
• Slow capillary refill
• Skin pallor or petechiae may be suggestive of hemolysis among patients who develop hemolytic uremic syndrome

HEENT

• Sunken fontanelles in infants
• Sunken eyes
• Absent tears in children
• Dry mucous membranes

Abdomen

• Abdominal tenderness (usually diffuse)
• Bloody stools and/or rectal tenderness may be present on rectal examination

Neurologic

• Altered mental status may be present in cases of severe dehydration, especially among elderly and pediatric patients