HIV AIDS physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Ujjwal Rastogi, MBBS; Ammu Susheela, M.D. [2]

Overview

The physical examination of a patient with HIV/AIDS can be variable depending on the stage of the disease. Physical exam findings may be related to the virus itself or secondary to the opportunistic infections of late disease. Findings include fever, lymphadenopathy, rash, oral thrush, retinal infiltrates, crackles on auscultation, and focal neurologic deficits.

Physical Examination

General Appearance of the patient

The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.

Vitals

Temperature

• Fever can be present.

Pulse

• Tachycardia can be present.

Blood pressure

• Hypotension can be present.

Respiratory rate

• Tachypnea can be seen during fever and respiratory tract infections

Skin

• Folliculitis can be present.
• Seborrheic dermatitis can be present.
• Psoriasis can be present.
• Skin lesions can be present in some cases.

Eyes

• Retinal hemorrhage may be present.
• Retinal infiltrates may be present.

Head

• Tenderness of sinuses may be elicited.

Nose

• Inflammation of the nasal turbinates may be present.

Ears

• Unilateral or bilateral deafness may be present.
• Discharge from the ears may be found.

Throat

• Peridontal disease may be present.
• Oral herpes simplex lesions may be found.
• Oral thrush may be found.

Lungs

• Crackles and rhonchi may be found.
• Dullness to percussion can be present.
• Increased tactile fremitus can be present.

Cardiovascular system

• A heart murmur can be found.

Abdomen

• Abdominal tenderness can be found.
• Hepatomegaly may be detected.
• Splenomegaly may be detected.

Genitourinary

• Vaginal or urethral discharge can be present.

Extremities

• Muscle weakness may be present.
• Joint swelling may be present.

Central Nervous System

• Focal neurological deficits may be found.

• Behavioral changes may be observed.
• Gait disturbances may be present.