Cryptococcosis 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]

Cryptococcosis Microchapters

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Overview

Physical examination findings in patients with cryptococcal meningitis include fever, nystagmus, papilledema, and cranial nerve deficits. Cutaneous cryptococcal infection will demonstrate erythematous papules, pustules, nodules, and ulcers. Rales can be heard on auscultation in pulmonary cryptococcus infection.

Physical Examination

General appearance of patient

Vitals

Temperature

HEENT

Neck

Skin

Erythematous papules, pustules, and ulcers may be present on examination[2]

Heart

Neuromuscular

Special tests

Following are the special tests for meningitis. Positive tests provide a strong suspicion for meningeal irritation:[5]

  • Exacerbation of headache by moving head in horizontal direction two to three times indicates a positive test

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References

  1. Kestelyn P, Taelman H, Bogaerts J, Kagame A, Abdel Aziz M, Batungwanayo J, Stevens AM, Van de Perre P (1993). "Ophthalmic manifestations of infections with Cryptococcus neoformans in patients with the acquired immunodeficiency syndrome". Am. J. Ophthalmol. 116 (6): 721–7. PMID 8250075.
  2. Christianson JC, Engber W, Andes D (2003). "Primary cutaneous cryptococcosis in immunocompetent and immunocompromised hosts". Med. Mycol. 41 (3): 177–88. PMID 12964709.
  3. Kalmar AF, Van Aken J, Caemaert J, Mortier EP, Struys MM (2005). "Value of Cushing reflex as warning sign for brain ischaemia during neuroendoscopy". Br J Anaesth. 94 (6): 791–9. doi:10.1093/bja/aei121. PMID 15805143.
  4. Fassbinder W (1989). "[Responsibilities of the internist in kidney transplantation]". Verh Dtsch Ges Inn Med (in German). 95: 515–26. PMID 2690522.
  5. 5.0 5.1 5.2 Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clin Infect Dis. 35 (1): 46–52. doi:10.1086/340979. PMID 12060874.
  6. Uchihara T, Tsukagoshi H (1991). "Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis". Headache. 31 (3): 167–71. PMID 2071396.
  7. "Public Health Image Library (PHIL)".

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