Gangrene physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
Patients with gangrene may have varying presentations depending on the type of gangrene they have.
Physical Examination
Patients with gangrene may have varying presentations depending on the type of gangrene they have. Table 1 provides a summary of typical physical examination of a patient with gangrene.
| System | Findings | |
|---|---|---|
| General Appearance | Patient with gangrene usually appears conscious, coherent, and in cardiorespiratory distress. | |
| Vital Signs | Patient is usually hypotensive and febrile. [1] [2] | |
| HEENT | Head can be normocephalic. | |
| Eyes can be normal. | ||
| Ears can be normal. | ||
| Nose can be normal. | ||
| Throat can be normal. | ||
| Chest / Lungs | Gangrene can lead to sepsis which may manifest with decreased chest expansion and decreased breath sounds. | |
| Cardiovascular | Gangrene can lead to sepsis which may manifest with dynamic precordium, irregular heart rate, irregular heart rhythm, and heart murmurs. | |
| Abdomen | Patient usually has no pertinent findings. | |
| Skin / Extremities | Patient usually has no pertinent findings. | |
| Dry Gangrene - The affected part is shrunken, dry, and appears dark black. | ||
| Wet Gangrene - The affected part is soft, dark, and edematous with putrid smell. | ||
| Gas Gangrene- Gas gangrene can lead to necrosis. | ||
| Skin / Genitalia | The genitals can be hyperemic, necrotic, and edematous with purulent suppuration.[3] | |
| Neurologic | Patients can be somnolent, confused, and not coherent due to sepsis. |
References
- ↑ Chelsom J, Halstensen A, Haga T, Høiby EA (1994). "Necrotising fasciitis due to group A streptococci in western Norway: incidence and clinical features". Lancet. 344 (8930): 1111–5. doi:10.1016/s0140-6736(94)90629-7. PMID 7934492.
- ↑ Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM; et al. (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A." N Engl J Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990.
- ↑ Chernyadyev SA, Ufimtseva MA, Vishnevskaya IF, Bochkarev YM, Ushakov AA, Beresneva TA; et al. (2018). "Fournier's Gangrene: Literature Review and Clinical Cases". Urol Int. 101 (1): 91–97. doi:10.1159/000490108. PMC 6106138. PMID 29949811.