Q fever physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with Q fever usually appear ill. Physical examination of patients with Q fever is usually remarkable for fever, pneumonia, and hepatomegaly.
Physical examination:
Vital signs:
- Fever: High grade fevers that is usually accompanied by chills and sweats[1][2]
- 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[3]
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
- ↑ Ishikawa H, Maeda H, Takamatsu H, Saito Y (1979). "Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure". Arch. Dermatol. Res. 265 (2): 195–206. PMID 88923.
- ↑ Marrie TJ (1990). "Q fever - a review". Can. Vet. J. 31 (8): 555–63. PMC 1480833. PMID 17423643.
- ↑ Derrick EH (1983). ""Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation". Rev. Infect. Dis. 5 (4): 790–800. PMID 6622891.