Actinomycosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

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

Physical Examination

Vital Signs

• Fever
• Tachypnea

Oral cavity

• Oral ulcers can be seen in some patients
• Poor dental hygiene with dental caries

Lymph nodes

• In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.

Neck

• No masses

Cardiovascular system

• Regular rate and rhythm
• Normal S1, S2
• No murmurs, rubs, or gallops

Lungs

Findings consistent with parenchymal consolidation such as

• Dullness to percussion
• Increased fremitus
• Signs of pleura involvement such as pleuritic rub.

Abdominal

• Abdomen soft and non-distended with no scars or striations
• Abdominal mass which is non tender, mostly seen in RLQ.
• abdominal bruits ascultated
• Spleen not palpable, liver not palpable

Skin

• Nodular lesions which gradually increase in size and number resulting in multiple abscesses, and ultimately forming sinuses that open outside.
• Ulcerative lesions that bleed easily

Genitourinary system

• Pyuria
• Painful urination
• Pelvic mass
• Menometrorrhagia

Extremities

• Ulcers that bleed on touch

Neurological

Normal examination finding unless the infection is disseminated to brain resulting in meningitis,then findings include :

• Altered level of consciousness
• Nuchal rigidity

References

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