Q fever physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical examination:

Vital signs:

• Fever: High grade fevers that is usually accompanied by chills and night sweats.
• Tachycardia
• Tachypnea

General:

• Patient looks ill

Skin:

• Maculopapular or punctate rash
• Erythema nodosum
• Spider nevi if hepatic decompensation is present

HEENT:

• Jaundice
• Congested neck veins if endocarditis or myocarditis is complicated by heart failure

Lungs:

• Minimal auscultatory findings in most of the cases
• Crackles especially in the lower lung fields
• Decreased breath sounds if pleural effusion is present

Abdomen:

• Hepatomegaly
• Ascites if chronic hepatitis ensues

Heart:

• S3 due to hyperdynamic circulation
• New onset murmer if endocarditis is present
• Pericardial rub and distant heart sounds if pericarditis and pericardial effusion is present

Neurological examination:

• Neck rigidity and positive brudsiniski and kuring signs
• Signs of increased intracranial pressure (vomiting, convulsions, papilledema, etc)

Extremities:

• Tenderness on palpation of the affected joints and bones
• Lower limb edema in presence of heart failure

References

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