Lassa fever physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Synonyms and keywords: Lassa hemorrhagic fever; LHF
Overview
Lassa fever is commonly associated with fever on physical examination at admission. At advanced stages of the disease, physical examination findings are more pertinent and often include unstable vital signs, such as tachycardia or relative bradycardia, hypotension, and tachypnea. Physical examination may also be remarkable for abdominal tenderness and distension and neurological impairment.
Physical Examination
Appearance of the Patient
The general appearance of the patient depends on the severity of the disease. Typically, patients demonstrate prostration, may be nauseated and vomiting, and less commonly very ill looking[1].
Vitals
Temperature
- High-grade fever is often present in more than 80% of patients. Fever is the most common presenting sign.
Pulse
- Tachycardia
- Relative bradycardia
Blood Pressure
- Hypotension (SBP<90 mmHg and/or DBP<60 mmHg)
- Postural hypotension is common in dehydrated patients with inadequate volume repletion
Respiratory Rate
- Signs of respiratory difficulty may be present, such as:
- Intercostal retractions
- Paradoxical breathing
- Nasal flare
- Tachypnea often precedes death during final hours of infection.
Skin
- Uncontrolled bleeding from venipuncture can occur if there is platelet dysfunction.
Eyes
- Conjunctival hemorrhage is a the most common sign of abnormal clotting
Nose
- Epistaxis may be present.
- Nasal discharge may be present.
Throat
- Mucosal hyperemia of the oral cavity is a common finding.
Abdomen
- Abdominal tenderness may suggest pancreatitis, intestinal swelling, or mesenteric lymphadenopathy
- Abdominal distention may suggest paralytic ileus
- Tender hepatomegaly
- Splenomegaly
- Bowel sounds are usually present.
Extremities
- Edema may be present.
Neurologic
- Obtundation may be present.
- Stupor
- Coma
References
- ↑ Kyei NN, Abilba MM, Kwawu FK, Agbenohevi PG, Bonney JH, Agbemaple TK; et al. (2015). "Imported Lassa fever: a report of 2 cases in Ghana". BMC Infect Dis. 15 (1): 217. doi:10.1186/s12879-015-0956-2. PMC 4448534. PMID 26022703.