Brucellosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza Lukac Vishal Devarkonda, M.B.B.S[3]

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Overview

Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings.

Physical Examination

Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:[1][2][3][4][5][6][7][8][9][10][11][12]

Examination findings Brucellosis physical examination
Appearance of patient Patients are usually well-appearing
Vital Signs Pulse rate-Normal/Tachycardia with regular rhythm, normal volume

Temperature- Normal or elevated

Blood pressure- Normal

Respiratory rate-Normal/tachypnea (pneumonia/lung involvement)

Oxygen saturation- usually normal but some cases may have low oxygen saturation (lung involvement).

Blood glucose level- normal

Skin Skin examination may be normal or reveal the following:
HEENT Eye examination is usually normal but signs of uveitis may be present in few patients
Neck Neck examination is usually normal but cervical lymphadenopathy may be present in few patients
Lungs Brucellosis involving lung, may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
Heart Heart examination may reveal murmurs on auscultation (endocarditis)
Abdomen Abdominal examination may elicit:
Back Back examination is usually normal
Genitourinary Genitourinary examination may reveal:
Extremities
Neuromuscular
*Commonly observed

Reference

  1. Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017
  2. Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M; et al. (1996). "Complications associated with Brucella melitensis infection: a study of 530 cases."Medicine (Baltimore)75 (4): 195–211. PMID 8699960
  3. Mantur BG, Amarnath SK, Shinde RS (2007). "Review of clinical and laboratory features of human brucellosis."Indian J Med Microbiol25 (3): 188–202. PMID 17901634
  4. Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis."N Engl J Med352 (22): 2325–36. PMID 15930423
  5. Dean AS, Crump L, Greter H, Hattendorf J, Schelling E, Zinsstag J (2012). "Clinical manifestations of human brucellosis: a systematic review and meta-analysis". PLoS Negl Trop Dis. 6 (12): e1929. doi:10.1371/journal.pntd.0001929. PMC 3516581. PMID 23236528.
  6. Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management."Curr Clin Top Infect Dis15: 115–28. PMID 7546364
  7. Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  8. Zamani A, Kooraki S, Mohazab RA, Zamani N, Matloob R, Hayatbakhsh MR; et al. (2011). "Epidemiological and clinical features of Brucella arthritis in 24 children". Ann Saudi Med. 31 (3): 270–3. doi:10.4103/0256-4947.81543. PMC 3119967. PMID 21623056.
  9. Mousa AM, Bahar RH, Araj GF, Koshy TS, Muhtaseb SA, al-Mudallal DS; et al. (1990). "Neurological complications of brucella spondylitis."Acta Neurol Scand81 (1): 16–23. PMID 2330811
  10. Pappas G, Bosilkovski M, Akritidis N, Mastora M, Krteva L, Tsianos E (2003). "Brucellosis and the respiratory system."Clin Infect Dis37 (7): e95–9. PMID 13130417doi:10.1086/378125
  11. Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.
  12. Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME; et al. (2007). "Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations". PLoS Med. 4 (12): e317. doi:10.1371/journal.pmed.0040317. PMC 2222927. PMID 18162038.