Toxic shock syndrome physical examination: Difference between revisions
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{{CMG}} | {{CMG}}{{AE}}{{MIR}} | ||
==Physical Examination== | ==Physical Examination== | ||
===Vital Signs=== | ===Vital Signs=== | ||
* [[ | * [[Hypotension]]: [[systolic blood pressure]] of ≤90 mmHg for adults or less than fifth percentile by age for children <16 years of age, which may be unresponsive to fluid infusion even large amounts of [[isotonic]] [[intravenous fluids]] | ||
* | * [[Fever]] | ||
* [[Tachycardia]] (as a result of shock and hypotension) | |||
* [[Tachypnea]]: may be pressent as a result of pulmonary edema secondary to shock | |||
===Neurologic=== | ===Neurologic and psychologic=== | ||
* [[Cerebral edema]] | |||
* [[Seizure activity|Seizure]] activity | |||
* [[Headaches]], [[memory loss]],[[disorientation]] and poor [[concentration]] , | |||
* [[Somnolence]], [[irritability]], [[agitation]], and [[Hallucination|hallucinations]] | |||
* [[Confusion]] without any focal neurological findings | * [[Confusion]] without any focal neurological findings | ||
===Gastrointestinal=== | ===Gastrointestinal=== | ||
* [[Vomiting]] | * [[Vomiting]] | ||
* [[Diarrhea]] | * Watery [[Diarrhea]] | ||
* [[Hepatic failure|Hepatic Failure]]: Which may present with [[hepatomegaly]], [[hypoalbuminemia]], [[Edema|non-pitting edema]] | |||
=== | === Renal === | ||
* | * [[Renal failure|Prerenal failure]]: Decrease in urinary output, due to [[dehydration]] and [[shock]] | ||
* [[Metabolic Control Analysis|Metabolic abnormalities]] related to RF such as [[hypocalcemia]], [[hyponatremia]], and [[hypophosphatemia]] and their related signs and symptoms | |||
=== CardioPulmonary === | |||
* [[Pleural effusion|Pleural effusions]] | |||
* [[Pulmonary edema]] | |||
* [[Cardiac dysfunction]] | |||
===Skin and moucosa=== | |||
* Diffuse [[Pruritic disorders|pruritic]] [[maculopapular]] [[rash]] with palm and soles [[desquamation]] | |||
* [[Erythroderma]] | |||
* Superficial [[Ulcer|ulcerations]] that may lead to [[petechiae]], [[vesicles]], and bullae development | |||
* [[Conjunctiva|Conjunctival]]-[[Sclera|scleral hemorrhage]] and [[hyperemia]] of the [[vaginal]] and [[oropharyngeal]] [[mucosa]] | |||
* [[Edema|Non-pitting edema]] | |||
* Hair and nail loss | |||
*<ref name="urlTintinallis Emergency Medicine: A Comprehensive Study Guide, 8th edition - Judith Tintinalli, J. Stapczynski, O. John Ma, David M. Cline, Garth Meckler - Google Books">{{cite web |url=https://books.google.com/books?id=FNKLCgAAQBAJ&q=It%27s+main+characteristics+involve+diffuse,+red,+macular+rash+resembling+sunburn+that+can+also+involve+the+palms+and+soles.&dq=It%27s+main+characteristics+involve+diffuse,+red,+macular+rash+resembling+sunburn+that+can+also+involve+the+palms+and+soles.&hl=en&sa=X&ved=0ahUKEwjlq-LXoODTAhVF7CYKHQ3aDkoQ6AEIJzAA |title=Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8th edition - Judith Tintinalli, J. Stapczynski, O. John Ma, David M. Cline, Garth Meckler - Google Books |format= |work= |accessdate=}}</ref><ref name="pmid7282746">{{cite journal |vauthors=Chesney RW, Chesney PJ, Davis JP, Segar WE |title=Renal manifestations of the staphylococcal toxic-shock syndrome |journal=Am. J. Med. |volume=71 |issue=4 |pages=583–8 |year=1981 |pmid=7282746 |doi= |url=}}</ref> | |||
*<ref name="pmid2928649">{{cite journal |vauthors=Olson RD, Stevens DL, Melish ME |title=Direct effects of purified staphylococcal toxic shock syndrome toxin 1 on myocardial function of isolated rabbit atria |journal=Rev. Infect. Dis. |volume=11 Suppl 1 |issue= |pages=S313–5 |year=1989 |pmid=2928649 |doi= |url=}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:35, 10 May 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Physical Examination
Vital Signs
- Hypotension: systolic blood pressure of ≤90 mmHg for adults or less than fifth percentile by age for children <16 years of age, which may be unresponsive to fluid infusion even large amounts of isotonic intravenous fluids
- Fever
- Tachycardia (as a result of shock and hypotension)
- Tachypnea: may be pressent as a result of pulmonary edema secondary to shock
Neurologic and psychologic
- Cerebral edema
- Seizure activity
- Headaches, memory loss,disorientation and poor concentration ,
- Somnolence, irritability, agitation, and hallucinations
- Confusion without any focal neurological findings
Gastrointestinal
- Vomiting
- Watery Diarrhea
- Hepatic Failure: Which may present with hepatomegaly, hypoalbuminemia, non-pitting edema
Renal
- Prerenal failure: Decrease in urinary output, due to dehydration and shock
- Metabolic abnormalities related to RF such as hypocalcemia, hyponatremia, and hypophosphatemia and their related signs and symptoms
CardioPulmonary
Skin and moucosa
- Diffuse pruritic maculopapular rash with palm and soles desquamation
- Erythroderma
- Superficial ulcerations that may lead to petechiae, vesicles, and bullae development
- Conjunctival-scleral hemorrhage and hyperemia of the vaginal and oropharyngeal mucosa
- Non-pitting edema
- Hair and nail loss
References
- ↑ "Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8th edition - Judith Tintinalli, J. Stapczynski, O. John Ma, David M. Cline, Garth Meckler - Google Books".
- ↑ Chesney RW, Chesney PJ, Davis JP, Segar WE (1981). "Renal manifestations of the staphylococcal toxic-shock syndrome". Am. J. Med. 71 (4): 583–8. PMID 7282746.
- ↑ Olson RD, Stevens DL, Melish ME (1989). "Direct effects of purified staphylococcal toxic shock syndrome toxin 1 on myocardial function of isolated rabbit atria". Rev. Infect. Dis. 11 Suppl 1: S313–5. PMID 2928649.