Monkeypox physical examination: Difference between revisions
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The skin lesions usually develop simultaneously as macular (1-2 days), then evolve to papular (1-2 days), vesicular (1-2 days), pustular (5-7 days), and finally scabs (7-14 days). | The skin lesions usually develop simultaneously as macular (1-2 days), then evolve to papular (1-2 days), vesicular (1-2 days), pustular (5-7 days), and finally scabs (7-14 days). | ||
===Neck=== | ===Neck=== | ||
*[[Lymphadenopathy]] (submental, submandibular, cervical) | |||
*[[Lymphadenopathy]] ( | |||
===Genitourinary=== | ===Genitourinary=== | ||
Revision as of 11:35, 15 June 2022
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Monkeypox Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Bassel Almarie, M.D.
Overview
Physical Examination
Vital Signs
- Low-grade fever (temperature, 100.8°F, 38.2°C)[1]
- Fever before rash is a key characteristics to identifying monkeypox[2]
Skin
Skin lesions develop after the prodrome (early set of symptoms). The United States Centers for Disease Control and Prevention described with following characteristics of lesions to identify monkeypox[2]:
- Relatively the same size and same stage of development on a single site of the body
- Well-circumscribed, deep seated, and often develop umbilication (resembles a dot on the top of the lesion)
- Disseminated rash is centrifugal (more lesions on extremities, face)
- Includes palms and soles
- often painful until the healing phase when they become itchy (crusts)
The skin lesions usually develop simultaneously as macular (1-2 days), then evolve to papular (1-2 days), vesicular (1-2 days), pustular (5-7 days), and finally scabs (7-14 days).
Neck
- Lymphadenopathy (submental, submandibular, cervical)
Genitourinary
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
- Clear/(color), foul-smelling/odorless penile/vaginal discharge
Write additional pathognomonic findings, such as discharge that resembles cottage cheese for C. albicans vulvovaginitis / fish-odor for T. vaginalis ifnection
Extremities
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status
- Glasgow coma scale is ___ / 15
- Clonus may be present
- Hyperreflexia / hyporeflexia / areflexia
- Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
References
- ↑ Fleischauer AT, Kile JC, Davidson M, Fischer M, Karem KL, Teclaw R; et al. (2005). "Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers". Clin Infect Dis. 40 (5): 689–94. doi:10.1086/427805. PMID 15714414.
- ↑ 2.0 2.1 "Clinical Recognition | Monkeypox | Poxvirus | CDC". Retrieved 2022-06-15.