Typhoid fever physical examination: Difference between revisions
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! Second Week<ref name="pmid22357703">{{cite journal| author=Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD et al.| title=A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1091-9 | pmid=22357703 | doi=10.1093/cid/cis025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357703 }} </ref> | ! Second Week<ref name="pmid22357703">{{cite journal| author=Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD et al.| title=A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1091-9 | pmid=22357703 | doi=10.1093/cid/cis025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357703 }} </ref> | ||
! Third Week | ! Third Week | ||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | General Appearance | ! rowspan="1" | General Appearance | ||
| Line 25: | Line 20: | ||
| colspan="1" style="width: 400px;" | Patient is in acute distress | | colspan="1" style="width: 400px;" | Patient is in acute distress | ||
| colspan="1" style="width: 400px;" | Patient is in severe distress | | colspan="1" style="width: 400px;" | Patient is in severe distress | ||
|- valign="top" | |||
! rowspan="1" | Vital signs | |||
| colspan="1" style="width: 400px;" | Normal to mild pallor | |||
| colspan="1" style="width: 400px;" | Pallor++, rose spots on the lower chest and abdomen(1/3 patients) | |||
| colspan="1" style="width: 400px;" | Pallor+++ | |||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | Skin | ! rowspan="1" | Skin | ||
| Line 37: | Line 37: | ||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | CV | ! rowspan="1" | CV | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Bradycardia | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Bradycardia | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Irregular rate and rhythm murmers(myocarditis) | ||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | Pulmonary | ! rowspan="1" | Pulmonary | ||
| colspan="1" style="width: 400px;" | First week findings | | colspan="1" style="width: 400px;" | First week findings | ||
| colspan="1" style="width: 400px;" | Second week findings | | colspan="1" style="width: 400px;" | Second week findings | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | crepitations(Pneumonia) | ||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | Abdomen | ! rowspan="1" | Abdomen | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Abdominal tenderness+ | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Abdominal tenderness++ | ||
| colspan="1" style="width: 400px;" | Tenderness++, absent bowel sounds | | colspan="1" style="width: 400px;" | Tenderness+++, absent bowel sounds (peritonitis) | ||
|- valign="top" | |- valign="top" | ||
! rowspan="1" | Neurological | ! rowspan="1" | Neurological | ||
| Line 59: | Line 59: | ||
| colspan="1" style="width: 400px;" | First week findings | | colspan="1" style="width: 400px;" | First week findings | ||
| colspan="1" style="width: 400px;" | Second week findings | | colspan="1" style="width: 400px;" | Second week findings | ||
| colspan="1" style="width: 400px;" | | | colspan="1" style="width: 400px;" | Joint swelling and tenderness | ||
|} | |} | ||
Revision as of 19:38, 31 August 2016
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Typhoid fever Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Typhoid fever physical examination On the Web |
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American Roentgen Ray Society Images of Typhoid fever physical examination |
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Risk calculators and risk factors for Typhoid fever physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Physical examination
| Organ System | First Week | Second Week[1] | Third Week |
|---|---|---|---|
| General Appearance | Patient may be in mild distress | Patient is in acute distress | Patient is in severe distress |
| Vital signs | Normal to mild pallor | Pallor++, rose spots on the lower chest and abdomen(1/3 patients) | Pallor+++ |
| Skin | Normal to mild pallor | Pallor++, rose spots on the lower chest and abdomen(1/3 patients) | Pallor+++ |
| HEENT | Second week findings | Third week findings | |
| CV | Bradycardia | Bradycardia | Irregular rate and rhythm murmers(myocarditis) |
| Pulmonary | First week findings | Second week findings | crepitations(Pneumonia) |
| Abdomen | Abdominal tenderness+ | Abdominal tenderness++ | Tenderness+++, absent bowel sounds (peritonitis) |
| Neurological | First week findings | Second week findings | Delirium or agitation |
| Musculoskeletal | First week findings | Second week findings | Joint swelling and tenderness |
- Slowly rising temperature with relative bradycardia
- Malaise
- Headache
- Cough
- Epistaxis
- Abdominal pain
- Prostration
- High grade fever which plateaus around 40°C
- Bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave.
- Delirium or agitation (nervous fever)
- Rose spots on the lower chest and abdomen(1/3 patients).
- Rhonchi in lung bases.
- Painful abdomen(right lower quadrant).
- Diarrhea (six to eight stools/day), green with a characteristic smell, comparable to pea-soup.[2]
- Constipation
- Intestinal hemorrhage
- Intestinal perforation in distal ileum(Fatal)
- Septicaemia or diffuse peritonitis[3]
- Encephalitis
- Metastatic abscesses
- Cholecystitis
- Endocarditis
- Osteitis
- Defervescence
References
- ↑ Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD; et al. (2012). "A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009". Clin Infect Dis. 54 (8): 1091–9. doi:10.1093/cid/cis025. PMID 22357703.
- ↑ Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE; et al. (1991). "Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area". Arch Intern Med. 151 (2): 381–2. PMID 1899554.
- ↑ Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR; et al. (1984). "Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone". N Engl J Med. 310 (2): 82–8. doi:10.1056/NEJM198401123100203. PMID 6361558.