Middle East respiratory syndrome coronavirus infection physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with MERS-CoV infection typically present with vital signs derangement, such as high-grade fever, tachycardia, tachypnea, and decreased oxygen saturation. Signs on physical examination may include decreased breath sounds, crackles, dullness on percussion, and increased tactile fremitus on pulmonary auscultation. Signs of complications may also be present, such as profound hypotension (suggestive of shock) or pericardial rub (suggestive of pericarditis).<ref name="pmid24841273">{{cite journal| author=Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J et al.| title=Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection. | journal=Antimicrob Agents Chemother | year= 2014 | volume= | issue= | pages= | pmid=24841273 | doi=10.1128/AAC.03036-14 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24841273 }} </ref><ref name=WHO>{{cite web | title = Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do | url = http://www.who.int/csr/disease/coronavirus_infections/InterimGuidance_ClinicalManagement_NovelCoronavirus_11Feb13u.pdf }}</ref><ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref> | |||
==Physical Examination== | ==Physical Examination== | ||
Typical signs on physical examination for MERS-CoV primary infection are shown below. Additionally, signs for MERS-CoV-associated [[Middle East respiratory syndrome coronavirus infection #Natural history, complications & prognosis|complications]] may also be present. | |||
===General Appearance=== | |||
*Hospitalized patients are usually sick-looking and may be in a critically ill condition.<ref name=CDC>{{cite web | title = Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a4.htm }}</ref><ref name="MemishZumla2013">{{cite journal|last1=Memish|first1=Ziad A.|last2=Zumla|first2=Alimuddin I.|last3=Assiri|first3=Abdullah|title=Middle East Respiratory Syndrome Coronavirus Infections in Health Care Workers|journal=New England Journal of Medicine|volume=369|issue=9|year=2013|pages=884–886|issn=0028-4793|doi=10.1056/NEJMc1308698}}</ref> | |||
===Vital Signs=== | ===Vital Signs=== | ||
* [[Hypotension]] | * [[Hypotension]] | ||
* [[Tachycardia]] | * [[Tachycardia]] | ||
* [[Tachypnea]] | * [[Tachypnea]] | ||
* [[Fever]] | * [[Fever]] (typically high-grade) | ||
* [[Decreased oxygen saturation]] | * [[Decreased oxygen saturation]] | ||
=== | ===HEENT=== | ||
*Tonsillar swelling | |||
* | |||
=== | ===Cardiothoracic=== | ||
* | *[[Stridor]] | ||
*Decreased [[breath sounds]] | |||
*[[Crackles]], [[rhonchi]], [[wheezing]] on pulmonary auscultation | |||
* | *Dullness on thoracic percussion | ||
*Increased [[tactile fremitus]] | |||
*High intensity [[egophony]] | |||
==References== | ==References== | ||
| Line 37: | Line 35: | ||
{{WS}} | {{WS}} | ||
[[category:disease]] | [[category:disease]] | ||
[[category:virology]] | [[category:virology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
Latest revision as of 18:05, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Patients with MERS-CoV infection typically present with vital signs derangement, such as high-grade fever, tachycardia, tachypnea, and decreased oxygen saturation. Signs on physical examination may include decreased breath sounds, crackles, dullness on percussion, and increased tactile fremitus on pulmonary auscultation. Signs of complications may also be present, such as profound hypotension (suggestive of shock) or pericardial rub (suggestive of pericarditis).[1][2][3]
Physical Examination
Typical signs on physical examination for MERS-CoV primary infection are shown below. Additionally, signs for MERS-CoV-associated complications may also be present.
General Appearance
Vital Signs
- Hypotension
- Tachycardia
- Tachypnea
- Fever (typically high-grade)
- Decreased oxygen saturation
HEENT
- Tonsillar swelling
Cardiothoracic
- Stridor
- Decreased breath sounds
- Crackles, rhonchi, wheezing on pulmonary auscultation
- Dullness on thoracic percussion
- Increased tactile fremitus
- High intensity egophony
References
- ↑ Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J; et al. (2014). "Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection". Antimicrob Agents Chemother. doi:10.1128/AAC.03036-14. PMID 24841273.
- ↑ "Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do" (PDF).
- ↑ 3.0 3.1 "MERS Prevention and Treatment".
- ↑ Memish, Ziad A.; Zumla, Alimuddin I.; Assiri, Abdullah (2013). "Middle East Respiratory Syndrome Coronavirus Infections in Health Care Workers". New England Journal of Medicine. 369 (9): 884–886. doi:10.1056/NEJMc1308698. ISSN 0028-4793.