Leptospirosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Physical Examination Findings

Appearance of the Patient

• Patient present with irritability and restlessness.

Vital Signs

• Hypotension and circulatory collapse.
• Tachypnea
• Tachycardia

Skin

• Macular, maculopapular erythematous skin eruptions are seen in the face and trunk.
• Purpura due to thrombocytopenia.

HEENT

• Icteric sclera is seen in patients with icteric leptospirosis
• Conjunctival suffusion: a charecterestic finding seen in patients with anicteric leptosirosis. Usually bilaeral and involving palpebral conjunctiva.
• Conjunctival hemorrhages: may be unilateral or bilateral.

Lungs

• Crepitations common in basal regions

Abdomen

• Right upper quadrant tenderness

• Hepatomegaly

Extremities

• Edema of the extremities
• cold clammy extremities

Neuromuscular

Signs of meningitis such as neck stiffness, nuchal rigidity are present.

Other signs include:

• Nystagmus
• Spasticity