Typhoid fever physical examination
|
Typhoid fever Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Typhoid fever physical examination On the Web |
|
American Roentgen Ray Society Images of Typhoid fever physical examination |
|
Risk calculators and risk factors for Typhoid fever physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Physical examination
Physical examination findings are described in the following table[1][2]
| Organ System | First Week | Second Week[3] | Third Week |
|---|---|---|---|
| General Appearance | Patient may be in mild distress | Patient is in acute distress | Patient is in severe distress, delirious or unconscious[4] |
| Vital signs | Stepwise increase in temperature, bradycardia[5] | High grade fever which plateaus around 40°C | Rising pulse, and falling blood pressure (shock), decreased or increased temperature[4] |
| Skin | Normal to mild pallor | Pallor++, blanching erythematous maculopapular lesions on the lower chest and abdomen(1/3 patients) | Pallor+++ (intestinal bleeding) |
| HEENT | Mild dehydration | Lymphadenopathy, conjuctival pallor | sunken eyes dry skin, coated dry tongue, |
| CV | Bradycardia | Bradycardia | Irregular rate, rhythm and murmers (myocarditis)[6] |
| Pulmonary | Normal | Ronchi(few) | Crepitations (Pneumonia) |
| Abdomen | Normal to mild tenderness | Abdominal tenderness++, distension+ | Tenderness+++(right lower quadrant), hepatosplenomegaly, absent bowel sounds (peritonitis)[3] |
| Neurological | Alert and oriented | Altered level of consciousness | Delirium or agitation |
| Musculoskeletal | Normal | Mild muscle or joint tenderness | Joint swelling and tenderness |
- Slowly rising temperature with relative bradycardia
- Malaise
- Headache
- Cough
- Epistaxis
- Abdominal pain
- Intestinal hemorrhage
- Intestinal perforation in distal ileum(Fatal)
- Septicaemia or diffuse peritonitis[4]
- Encephalitis
- Metastatic abscesses
- Cholecystitis
- Endocarditis
- Osteitis
- Defervescence
References
- ↑ Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002). "Typhoid fever". N Engl J Med. 347 (22): 1770–82. doi:10.1056/NEJMra020201. PMID 12456854.
- ↑ Azmatullah A, Qamar FN, Thaver D, Zaidi AK, Bhutta ZA (2015). "Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever". J Glob Health. 5 (2): 020407. doi:10.7189/jogh.05.020407. PMC 4672836. PMID 26649174.
- ↑ 3.0 3.1 Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD; et al. (2012). "A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009". Clin Infect Dis. 54 (8): 1091–9. doi:10.1093/cid/cis025. PMID 22357703.
- ↑ 4.0 4.1 4.2 Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR; et al. (1984). "Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone". N Engl J Med. 310 (2): 82–8. doi:10.1056/NEJM198401123100203. PMID 6361558.
- ↑ Ostergaard L, Huniche B, Andersen PL (1996). "Relative bradycardia in infectious diseases". J Infect. 33 (3): 185–91. PMID 8945708.
- ↑ Villablanca P, Mohananey D, Meier G, Yap JE, Chouksey S, Abegunde AT (2015). "Salmonella Berta myocarditis: Case report and systematic review of non-typhoid Salmonella myocarditis". World J Cardiol. 7 (12): 931–7. doi:10.4330/wjc.v7.i12.931. PMC 4691820. PMID 26730299.