Cytomegalovirus infection physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic
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 present.
HEENT
Eyes
On fundus examination the following findings can be demonstrated in patients with CMV retinitis:
- Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
- Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
- Blood vessels appear sheathed.
- If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.
Cardiovascular
- Normal heart sounds
- No murmurs, gallops or rubs
Lungs
Abdomen
- Abdominal tenderness
- Abdominal distension can be present on examination in patients with CMV colitis.
Central Nervous System
The following examination findings can be present in CMV encephalitis:
- Focal neurological deficits
- Altered mental status
- Hypotonia
- Normal or diminished deep tendon reflexes