Q fever physical examination: Difference between revisions
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Patients with Q fever usually appear ill. Physical examination of patients with Q fever is usually remarkable for [[fever]], [[pneumonia]], and [[hepatomegaly]]. | Patients with Q fever usually appear ill. Physical examination of patients with Q fever is usually remarkable for [[fever]], [[pneumonia]], and [[hepatomegaly]]. | ||
==Physical examination | ==Physical examination== | ||
===Vital signs | ===Vital signs=== | ||
*[[Fever]]: [[Fever|High grade fevers]] that is usually accompanied by [[chills]] and [[sweats]]<ref name="pmid88923">{{cite journal |vauthors=Ishikawa H, Maeda H, Takamatsu H, Saito Y |title=Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure |journal=Arch. Dermatol. Res. |volume=265 |issue=2 |pages=195–206 |year=1979 |pmid=88923 |doi= |url=}}</ref><ref name="pmid17423643">{{cite journal |vauthors=Marrie TJ |title=Q fever - a review |journal=Can. Vet. J. |volume=31 |issue=8 |pages=555–63 |year=1990 |pmid=17423643 |pmc=1480833 |doi= |url=}}</ref> | *[[Fever]]: [[Fever|High grade fevers]] that is usually accompanied by [[chills]] and [[sweats]]<ref name="pmid88923">{{cite journal |vauthors=Ishikawa H, Maeda H, Takamatsu H, Saito Y |title=Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure |journal=Arch. Dermatol. Res. |volume=265 |issue=2 |pages=195–206 |year=1979 |pmid=88923 |doi= |url=}}</ref><ref name="pmid17423643">{{cite journal |vauthors=Marrie TJ |title=Q fever - a review |journal=Can. Vet. J. |volume=31 |issue=8 |pages=555–63 |year=1990 |pmid=17423643 |pmc=1480833 |doi= |url=}}</ref> | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
*[[Tachypnea]] | *[[Tachypnea]] | ||
===General | ===General=== | ||
*Patient looks ill | *Patient looks ill | ||
===Skin | ===Skin=== | ||
*[[Maculopapular]] or punctate [[rash]] | *[[Maculopapular]] or punctate [[rash]] | ||
*[[Erythema nodosum]] | *[[Erythema nodosum]] | ||
*[[Spider nevi]] if [[Hepatic failure|hepatic decompensation]] is present | *[[Spider nevi]] if [[Hepatic failure|hepatic decompensation]] is present | ||
===HEENT | ===HEENT=== | ||
*[[Jaundice]] | *[[Jaundice]] | ||
*[[Neck veins|Congested neck veins]] if [[endocarditis]] or [[myocarditis]] is complicated by [[heart failure]]<ref name="pmid6622891">{{cite journal |vauthors=Derrick EH |title="Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation |journal=Rev. Infect. Dis. |volume=5 |issue=4 |pages=790–800 |year=1983 |pmid=6622891 |doi= |url=}}</ref> | *[[Neck veins|Congested neck veins]] if [[endocarditis]] or [[myocarditis]] is complicated by [[heart failure]]<ref name="pmid6622891">{{cite journal |vauthors=Derrick EH |title="Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation |journal=Rev. Infect. Dis. |volume=5 |issue=4 |pages=790–800 |year=1983 |pmid=6622891 |doi= |url=}}</ref> | ||
===Lungs | ===Lungs=== | ||
*Minimal auscultatory findings in most of the cases | *Minimal auscultatory findings in most of the cases | ||
*[[Crackles]] especially in the lower lung fields | *[[Crackles]] especially in the lower lung fields | ||
*Decreased breath sounds if [[pleural effusion]] is present | *Decreased breath sounds if [[pleural effusion]] is present | ||
===Abdomen | ===Abdomen=== | ||
*[[Hepatomegaly]] | *[[Hepatomegaly]] | ||
*[[Ascites]] if [[chronic hepatitis]] ensues | *[[Ascites]] if [[chronic hepatitis]] ensues | ||
=== | ===Cardiovascular=== | ||
*[[S3]] due to [[hyperdynamic circulation]] | *[[S3]] due to [[hyperdynamic circulation]] | ||
*New onset murmer if [[endocarditis]] is present | *New onset murmer if [[endocarditis]] is present | ||
*[[Pericardial rub]] and distant heart sounds if [[pericarditis]] and [[pericardial effusion]] is present | *[[Pericardial rub]] and distant heart sounds if [[pericarditis]] and [[pericardial effusion]] is present | ||
===Neurological examination | ===Neurological examination=== | ||
*[[Neck rigidity]] and positive brudsiniski and kuring signs | *[[Neck rigidity]] and positive brudsiniski and kuring signs | ||
*Signs of increased [[intracranial pressure]] ([[vomiting]], [[convulsions]], [[Papilledema|papilledema,]] etc) | *Signs of increased [[intracranial pressure]] ([[vomiting]], [[convulsions]], [[Papilledema|papilledema,]] etc) | ||
===Extremities | ===Extremities=== | ||
*[[Tenderness]] on palpation of the affected joints and bones | *[[Tenderness]] on palpation of the affected joints and bones | ||
*[[Edema|Lower limb edema]] in presence of heart failure | *[[Edema|Lower limb edema]] in presence of heart failure | ||
Revision as of 23:42, 12 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with Q fever usually appear ill. Physical examination of patients with Q fever is usually remarkable for fever, pneumonia, and hepatomegaly.
Physical examination
Vital signs
- Fever: High grade fevers that is usually accompanied by chills and sweats[1][2]
- Tachycardia
- Tachypnea
General
- Patient looks ill
Skin
- Maculopapular or punctate rash
- Erythema nodosum
- Spider nevi if hepatic decompensation is present
HEENT
- Jaundice
- Congested neck veins if endocarditis or myocarditis is complicated by heart failure[3]
Lungs
- Minimal auscultatory findings in most of the cases
- Crackles especially in the lower lung fields
- Decreased breath sounds if pleural effusion is present
Abdomen
- Hepatomegaly
- Ascites if chronic hepatitis ensues
Cardiovascular
- S3 due to hyperdynamic circulation
- New onset murmer if endocarditis is present
- Pericardial rub and distant heart sounds if pericarditis and pericardial effusion is present
Neurological examination
- Neck rigidity and positive brudsiniski and kuring signs
- Signs of increased intracranial pressure (vomiting, convulsions, papilledema, etc)
Extremities
- Tenderness on palpation of the affected joints and bones
- Lower limb edema in presence of heart failure
References
- ↑ Ishikawa H, Maeda H, Takamatsu H, Saito Y (1979). "Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure". Arch. Dermatol. Res. 265 (2): 195–206. PMID 88923.
- ↑ Marrie TJ (1990). "Q fever - a review". Can. Vet. J. 31 (8): 555–63. PMC 1480833. PMID 17423643.
- ↑ Derrick EH (1983). ""Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation". Rev. Infect. Dis. 5 (4): 790–800. PMID 6622891.