Lassa fever physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Synonyms and keywords: Lassa hemorrhagic fever; LHF

Overview

Persistent, high-grade fever is the most common sign on physical examination. Other common signs on physical examination include tachycardia, tachypnea, conjunctival injection, abdominal/chest tenderness, pharyngitis with tonsillar exudates, and hepatosplenomegaly.

Physical Examination

General Appearance

• In distress
• Sick-looking

Vital Signs

• Persistent, high-grade fever
• Tachycardia or relative bradycardia
• Hypotension
• Tachypnea

Skin

• Uncontrolled bleeding from venipuncture sites
• Jaundice

HEENT and Neck

• Conjunctival injection
• Conjunctival hemorrhage
• Nasal flaring
• Epistaxis
• Nasal discharge
• Hearing impairment (abnormal Renne and Weber tests)
• Mucosal hyperemia of the oral cavity
• Pharyngitis with exudation
• Cervical lymphadenopathy

Thoracic

• Paradoxical breathing
• Chest tenderness

Abdomen

• Abdominal tenderness
• Abdominal distention
• Tender hepatomegaly
• Splenomegaly
• Bowel sounds may be hyperactive (bleeding) or hypoactive (ileus)

Extremities

• Extremity edema

Neurologic

• Obtundation
• Stupor
• Coma
• Tremor