Relapsing fever physical examination

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

Overview

he most evident finding is a moderately ill-appearing person who is mild to moderately dehydrated. Fever, tachycardia, and hepatosplenomegaly are common physical examination findings. Some people develop mild to moderate hepatosplenomegaly, enlarged liver, and spleen. Less frequently, lymphadenopathy, jaundice, abdominal tenderness, pulmonary rales, skin rash, meningismus, delirium, aphasia, hemiplegia, facial paralysis or other neurologic findings may be present.

Physical Examination

The most evident finding is a moderately ill-appearing person who is mild to moderately dehydrated.Fever, tachycardia, and hepatosplenomegaly are common physical examination findings. Some people develop mild to moderate hepatosplenomegaly, enlarged liver, and spleen. Less frequently, lymphadenopathy, jaundice, abdominal tenderness, pulmonary rales, skin rash, meningismus, delirium, aphasia, hemiplegia, facial paralysis or other neurologic findings may be present

• 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).

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)