Relapsing fever physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Most people who are infected get sick around 5-15 days after they are bitten by the tick. The symptoms may include a sudden fever, chills, headaches, and muscle or joint aches, arthralgias, sweats and nausea; a rash may also occur. These symptoms continue for 2-9 days, then disappear. This cycle may continue for several weeks if the person is not treated.[1] Other later symptoms may include nausea, vomiting, anorexia, dry cough, photophobia, rash, neck pain, eye pain, confusion and dizziness. [2]
Physical Examination
The most evident finding is a moderately ill-appearing person who is mild to moderately dehydrated and tachycardic.
- Some people develop mild to moderate hepatosplenomegaly, enlarged liver, and spleen. Other potential findings on clinical exam include meningismus (stiff neck and headache with photophobia), pleuritic pain, and rub (chest pain), photophobia (fear of light).
Skin
Often there is accompanying yellowing of the skin or jaundice. The skin exam can reveal a nonspecific rash. The rash may appear macular, papular or petechial, and usually begins as the symptoms of the primary attack resolve.
Eyes
Often there is conjunctivitis (red eyes) and sclarae icteric (yellowing of the white part of the eyes).[3]
Lungs
Pulmonary rales( less frequently)
Abdomen
Abdominal tenderness( less frequently)
Neurologic
- Meningismus( less frequently)
- Delirium( less frequently)
- Aphasia( less frequently)
- Hemiplegia* ( less frequently)
Facial paralysis or other neurologic findings may be present. ( less frequently)
References
- ↑ Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. pp. 432&ndash, 4. ISBN 0838585299.
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Symptoms.htm
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Symptoms.htm