Smallpox physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Depending on the stage of the disease, physical findings may include: high fever, tachycardia secondary to the fever, oral mucosa and skin rash with typical progression, ophthalmological changes, abdominal pain, and altered mental status.
Physical Examination
Appearance of the Patient
Depending on the stage of the disease, the smallpox patient may have different appearances. These may range from
- Asymptomatic, if it is a patient who had contact with someone with smallpox, got the infection, and is currently in the incubation period
- Extremely ill, if it is someone who is in the prodromal period and appears extremely ill, is vomiting and fatigued
Vitals
Temperature
- A fever is often present, particularly if in the prodromal period
Rate
- Tachycardia is often present
Blood Pressure
- Hypotension may be present
Skin
- A rash is often present
- Lesions may be present
Eyes
- Extra-ocular movements may be abnormal
- Pupils may not react to light
- Sclera may show inflammation, ulceration and/or hemorrhage
Throat
- The throat may be erythematous
- There may be exudate in the throat
- There may be petechiae seen in the throat
Abdomen
- Abdominal distention may be present
- Abdominal tenderness may be present
- Hepatomegaly may be present
- Splenomegaly may be present
Extremities
- Edema may be present
Neurologic
- Mental status may be altered
Images
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Man with smallpox -
Smallpox lesions on skin of trunk. Picture taken in Bangladesh, 1973. -
These smallpox pustules are round, smooth, deep, and all at the same stage. -
Smallpox eruptions on arm and palm. -
This photograph depicted a male smallpox patient whose skin displayed the characteristics of late-stage maculopapular scarring on his face, arms and chest.
