West nile virus physical examination

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

Overview

On physical examination, patients with WNV infection may have no specific signs. Physical examination findings may range from an isolated fever to signs of severe neurological impairment, meningeal irritation, stupor, and coma.

Physical exam

Most patients with WNV are asymptomatic or experience a mild disease that may often have no signs on physical examination.

Vital signs

• Fever
• Tachycardia
• Tachypnea

Skin

• Macular or Papular truncal rash

HEENT

• Papilledema
• Nystagmus
• Lymphadenopathy
• Non exudative pharyngeal erythema

Chest

• Ataxic or apneustic breathing

Abdomen

• Abdominal tenderness
• Splenomegaly
• Vesical fullness

Neurologic

• Altered mental status
• Tremor
• Myoclonus
• Bradykinesia
• Rigidity
• Absent corneal reflex
• Absent gag reflex
• Memory loss
• Sensory loss
• Motor weakness
• Neck stiffness
• Positive Kernig and Brudzinski tests
• Hyperreflexia
• Positive Babinski reflex