Whipple's disease physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Bhagyashree Deshmankar M.B.B.S.[2]
Overview
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Physical Examination
- Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
- The presence of [finding(s)] on physical examination is diagnostic of [disease name].
- The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
- Patients with Whipple's disease may appear weak and tried some times severe enough to cause cachexia secondary to malabsorption and weight loss. 2
Vital Signs
- Low-grade intermittent fever may be present in some patients. it might be associated with night sweats [1]
Skin
- Hyperpigmentation may be present in some patients. It is more frequent in sun exposed areas. [1]
- Some patients may develop skin nodules
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Description (Adapted from Dermatology Atlas)
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Description (Adapted from Dermatology Atlas)
HEENT
- Nystagmus
- Extra-ocular movements may be abnormal. Oculomasticatory, or oculofacialskeletal, myorhythmia are pathognomic. [1]
Neck
- Lymphadenopathy is common. Peripheral lymph nodes may be palpable. [1]
Lungs
- Asymmetric chest expansion / Decreased chest expansion
- Lungs are hypo/hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- Rhonchi
- Vesicular breath sounds / Distant breath sounds
- Expiratory/inspiratory wheezing with normal / delayed expiratory phase
- Wheezing may be present
- Egophony present/absent
- Bronchophony present/absent
- Normal/reduced tactile fremitus
Heart
- A systolic murmur may be heard in patients with cardiac valve involvement. [1]
Abdomen
- Abdominal bloating and cramps may be compained by some patients. [1]
- Hepatomegaly / splenomegaly / hepatosplenomegaly
Neuromuscular
- Patient may be asymptomatic or may have cognitive changes [1]
- Patient may have altered level of consciousness [1]
- Some patients may present with seizure[1]
- Myoclonus may be present
- Ataxia may be present [1]
Extremities
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity