Cytomegalovirus infection physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Physical Examination

• On fundus examination the following findings can be demonstrated:
  • Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
  • Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
  • Blood vessels appear sheathed.
  • If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.

General Appearance of the patient

The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.

Vitals

Temperature

• Fever can be present.

Pulse

• Tachycardia can be present.

Blood pressure

• Hypotension can be present.

Respiratory rate

• Tachypnea can be seen during fever and respiratory tract infections

Skin

• Folliculitis can be present.
• Seborrheic dermatitis can be present.
• Psoriasis can be present.
• Skin lesions can be present in some cases.

Eyes

• Retinal hemorrhage may be present.
• Retinal infiltrates may be present.

Head

• Tenderness of sinuses may be elicited.

Nose

• Inflammation of the nasal turbinates may be present.

Ears

• Unilateral or bilateral deafness may be present.
• Discharge from the ears may be found.

Throat

• Peridontal disease may be present.
• Oral herpes simplex lesions may be found.
• Oral thrush may be found.

Lungs

• Crackles and rhonchi may be found.
• Dullness to percussion can be present.
• Increased tactile fremitus can be present.

Cardiovascular system

• A heart murmur can be found.

Abdomen

• Abdominal tenderness can be found.
• Hepatomegaly may be detected.
• Splenomegaly may be detected.

Genitourinary

• Vaginal or urethral discharge can be present.

Extremities

• Muscle weakness may be present.
• Joint swelling may be present.

Central Nervous System

• Focal neurological deficits may be found.

• Behavioral changes may be observed.
• Gait disturbances may be present.