Histoplasmosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D., Aravind Kuchkuntla, M.B.B.S[2]

Overview

Physical examination findings in pulmonary histoplasmosis include erythema nodosum and rales on auscultation. In patients with disseminated histoplasmosis features similar to sepsis such as hypotension, altered mental status will be present.

Physical Examination

Physical examination findings vary in patients with histoplasma infection and it depends on stage of the disease and extent of the spread of infection. Patients with acute or chronic pulmonary histoplasmosis present with features similar to pneumonia.
[1] The following physical examination findings can be demonstrated:

General Appearance

Patient will appear ill with fever and dyspnea.

Skin

Lungs

In patients with acute or chronic pulmonary histoplasmosis occasional wheezing and rales are a common finding.

Palpation

Percussion
Auscultation

Disseminated Histoplasmosis

Patients with disseminated histoplasma infection have similar features as sepsis. The following physical examination findings can be demonstrated in a patient with disseminated infection:[2]

Vital Signs

Sepsis is considered present if infection is highly suspected or proven and two or more of the following systemic inflammatory response syndrome (SIRS) criteria are met:[3][4]

Skin

HEENT

Extremities

Neurologic

Gallery

References

  1. Knox KS, Hage CA (2010). "Histoplasmosis". Proc Am Thorac Soc. 7 (3): 169–72. doi:10.1513/pats.200907-069AL. PMID 20463244.
  2. Kauffman CA (2009). "Histoplasmosis". Clin Chest Med. 30 (2): 217–25, v. doi:10.1016/j.ccm.2009.02.002. PMID 19375629.
  3. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Critical Care Medicine. 36 (1): 296–327. doi:10.1097/01.CCM.0000298158.12101.41. PMID 18158437. Retrieved 2012-09-16. Unknown parameter |month= ignored (help)
  4. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.
  5. 5.0 5.1 5.2 "Public Health Image Library (PHIL)".