Filariasis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Filariasis patients appear toxic on presentation due to pain. They present with | Filariasis patients appear [[toxic]] on presentation due to [[pain]]. They present with [[fever]] called filarial fever. It is an acute self-limited fever present in the beginning of the disease. Edematous [[plaques]] may be observed and it is a sign of acute dermatolymphangioadenitis. In [[onchocerciasis]], [[blindness]] occurs and [[subcutaneous]] [[nodules]] may be found. [[Genitourinary]] manifestations are also observed in filariasis as [[hydrocele]], [[chyluria]], [[hematuria]] and [[Scrotal mass|scrotal]] [[elephantiasis]]. | ||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the patient=== | ===Appearance of the patient=== | ||
*Patients with filariasis appearance is toxic due to [[pain]]. | *Patients with filariasis appearance is [[toxic]] due to [[pain]]. | ||
===Vital signs=== | ===Vital signs=== | ||
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* Edematous [[plaques]] in acute phase of the disease as a sign of acute dermatolymphangioadenitis<ref name="pmid10674092">{{cite journal| author=Dreyer G, Medeiros Z, Netto MJ, Leal NC, de Castro LG, Piessens WF| title=Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes. | journal=Trans R Soc Trop Med Hyg | year= 1999 | volume= 93 | issue= 4 | pages= 413-7 | pmid=10674092 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10674092 }} </ref> | * Edematous [[plaques]] in acute phase of the disease as a sign of acute dermatolymphangioadenitis<ref name="pmid10674092">{{cite journal| author=Dreyer G, Medeiros Z, Netto MJ, Leal NC, de Castro LG, Piessens WF| title=Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes. | journal=Trans R Soc Trop Med Hyg | year= 1999 | volume= 93 | issue= 4 | pages= 413-7 | pmid=10674092 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10674092 }} </ref> | ||
* [[papule|Papular eruption]]s | * [[papule|Papular eruption]]s | ||
* Subcutaneous [[nodules]] in cases of onchocercomata | * [[Subcutaneous]] [[nodules]] in cases of [[Onchocercosis|onchocercomata]] | ||
===HEENT=== | ===HEENT=== | ||
* [[Blindness]]: | * [[Blindness]]: | ||
* In [[Onchocerciasis]], the most serious manifestation consists of ocular lesions that can progress to [[blindness|blindness.]]<ref name="pmid21803313">{{cite journal| author=Chandy A, Thakur AS, Singh MP, Manigauha A| title=A review of neglected tropical diseases: filariasis. | journal=Asian Pac J Trop Med | year= 2011 | volume= 4 | issue= 7 | pages= 581-6 | pmid=21803313 | doi=10.1016/S1995-7645(11)60150-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21803313 }} </ref> | * In [[Onchocerciasis]], the most serious manifestation consists of [[ocular]] lesions that can progress to [[blindness|blindness.]]<ref name="pmid21803313">{{cite journal| author=Chandy A, Thakur AS, Singh MP, Manigauha A| title=A review of neglected tropical diseases: filariasis. | journal=Asian Pac J Trop Med | year= 2011 | volume= 4 | issue= 7 | pages= 581-6 | pmid=21803313 | doi=10.1016/S1995-7645(11)60150-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21803313 }} </ref> | ||
* Subconjunctival migration of an adult worm can be seen in [[Loiasis]]. | * Subconjunctival migration of an adult worm can be seen in [[Loiasis]]. | ||
===Lungs=== | ===Lungs=== | ||
* [[Rhonchi]] may be present in patients with pulmonary tropical eosinophilia syndrome. | * [[Rhonchi]] may be present in patients with [[Tropical pulmonary eosinophilia|pulmonary tropical eosinophilia syndrome]]. | ||
===Abdomen=== | ===Abdomen=== | ||
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===Genitourinary=== | ===Genitourinary=== | ||
There are genitourinary signs that may be detected in filariasis patients:<ref name="pmid1621900">{{cite journal| author=Dreyer G, Ottesen EA, Galdino E, Andrade L, Rocha A, Medeiros Z et al.| title=Renal abnormalities in microfilaremic patients with Bancroftian filariasis. | journal=Am J Trop Med Hyg | year= 1992 | volume= 46 | issue= 6 | pages= 745-51 | pmid=1621900 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1621900 }} </ref> | There are [[genitourinary]] signs that may be detected in filariasis patients:<ref name="pmid1621900">{{cite journal| author=Dreyer G, Ottesen EA, Galdino E, Andrade L, Rocha A, Medeiros Z et al.| title=Renal abnormalities in microfilaremic patients with Bancroftian filariasis. | journal=Am J Trop Med Hyg | year= 1992 | volume= 46 | issue= 6 | pages= 745-51 | pmid=1621900 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1621900 }} </ref> | ||
* [[Hydrocele]] | * [[Hydrocele]] | ||
* [[Elephantiasis due to filaria|Scrotal elephantiasis]] | * [[Elephantiasis due to filaria|Scrotal elephantiasis]] | ||
* [[Chyluria]] as a result of leakage of the lymph into the urine | * [[Chyluria]] as a result of leakage of the [[lymph]] into the [[urine]] | ||
* [[Hematuria]] | * [[Hematuria]] | ||
* [[Proteinuria]] | * [[Proteinuria]] | ||
Revision as of 15:06, 27 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Filariasis patients appear toxic on presentation due to pain. They present with fever called filarial fever. It is an acute self-limited fever present in the beginning of the disease. Edematous plaques may be observed and it is a sign of acute dermatolymphangioadenitis. In onchocerciasis, blindness occurs and subcutaneous nodules may be found. Genitourinary manifestations are also observed in filariasis as hydrocele, chyluria, hematuria and scrotal elephantiasis.
Physical Examination
Appearance of the patient
Vital signs
Skin
- Edematous plaques in acute phase of the disease as a sign of acute dermatolymphangioadenitis[1]
- Papular eruptions
- Subcutaneous nodules in cases of onchocercomata
HEENT
- Blindness:
- In Onchocerciasis, the most serious manifestation consists of ocular lesions that can progress to blindness.[2]
- Subconjunctival migration of an adult worm can be seen in Loiasis.
Lungs
- Rhonchi may be present in patients with pulmonary tropical eosinophilia syndrome.
Abdomen
Extremities
Genitourinary
There are genitourinary signs that may be detected in filariasis patients:[3]
- Hydrocele
- Scrotal elephantiasis
- Chyluria as a result of leakage of the lymph into the urine
- Hematuria
- Proteinuria
Other
References
- ↑ Dreyer G, Medeiros Z, Netto MJ, Leal NC, de Castro LG, Piessens WF (1999). "Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes". Trans R Soc Trop Med Hyg. 93 (4): 413–7. PMID 10674092.
- ↑ Chandy A, Thakur AS, Singh MP, Manigauha A (2011). "A review of neglected tropical diseases: filariasis". Asian Pac J Trop Med. 4 (7): 581–6. doi:10.1016/S1995-7645(11)60150-8. PMID 21803313.
- ↑ Dreyer G, Ottesen EA, Galdino E, Andrade L, Rocha A, Medeiros Z; et al. (1992). "Renal abnormalities in microfilaremic patients with Bancroftian filariasis". Am J Trop Med Hyg. 46 (6): 745–51. PMID 1621900.