Listeriosis physical examination: Difference between revisions

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Latest revision as of 22:31, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

The findings on the physical examination depend on the clinical manifestation of listeriosis. Common findings include fever, tachycardia, pallor, and abdominal tenderness. Signs of neurological involvement may include altered mental state, paralysis, respiratory failure, and coma.

Physical Examination

The findings on the physical examination depend on the clinical manifestation of listeriosis. Click on the links below for the exact clinical manifestation you are lookig for:

Febrile gastroenteritis
Infection in pregnancy
Sepsis of unknown origin
Meningoencephalitis
Encephalitis
Rhombencephalitis
Brain abscess
Spinal cord infection
Endocarditis

Febrile Gastroenteritis

Organ System	Findings
General Appearance	Patient is ill-looking
Vital Signs	Fever
	Tachycardia
	Tachypnea
	Hypotension
Skin	Pallor
HEENT	Dry mucous membranes
Neurologic	Altered mental status
Neurologic	Motor and sensory focal neurologic signs
Abdominal	Abdominal tenderness
Abdominal	Abdominal distention

Sepsis of Unknown Origin

Organ System	Findings
Vital Signs	Fever
	Tachycardia
	Tachypnea
	Hypotension
	Weak peripheral pulses
Skin	Pallor
Skin	Cyanosis
HEENT	Dry mucous membranes
	Lymphadenopathy
	Papilledema on fundoscopic exam
Neurologic	Altered mental status
Neurologic	Motor and sensory focal neurologic signs
Abdominal	Abdominal tenderness

Central Nervous System Infection

Organ System	Findings
Vital Signs	Fever
	Tachycardia
	Tachypnea
	Hypotension
	Weak peripheral pulses
Skin	Pallor
Skin	Skin rash
HEENT	Bulging fontanelles may be present (neonates)
	Papilledema on fundoscopic exam
	Neck stiffness may be present (typically absent in neonates)
Neurologic	Altered mental status
	Motor and sensory focal neurologic signs
	Autonomic dysfunction may be present
	Hemiparesis may be present
	Ataxia may be present
	Dystonia may be present

References

Template:WH Template:WS

@@ Line 4: / Line 4: @@
 ==Overview==
+The findings on the [[physical examination]] depend on the clinical manifestation of listeriosis. Common findings include [[fever]], [[tachycardia]], [[pallor]], and [[abdominal tenderness]].  Signs of [[neurological]] involvement may include [[altered mental state]], [[paralysis]], [[respiratory failure]], and [[coma]].
 ==Physical Examination==
-===Febrile Gastroenteritis===
+The findings on the [[physical examination]] depend on the clinical manifestation of listeriosis.  Click on the links below for the exact clinical manifestation you are lookig for:
-====Appearance of the Patient====
+* [[Listeriosis physical examination#Febrile Gastroenteritis|Febrile gastroenteritis]]
-A patient with [[listeriosis]] will likely appear ill, complaining of [[fever]], "body pain" and [[chills]]. Depending on the previous health status of the patient, the initial presentation may change, since this is an important factor in the evolution of the disease.
+* [[Listeriosis physical examination#Infection in Pregnancy|Infection in pregnancy]]
+* [[Listeriosis physical examination#Sepsis of Unknown Origin|Sepsis of unknown origin]]
+* [[Listeriosis physical examination#Meningoencephalitis|Meningoencephalitis]]
+* [[Listeriosis physical examination#Encephalitis|Encephalitis]]
+* [[Listeriosis physical examination#Rhombencephalitis|Rhombencephalitis]]
+* [[Listeriosis physical examination#Brain Abscess|Brain abscess]]
+* [[Listeriosis physical examination#Spinal Cord Infection|Spinal cord infection]]
+* [[Listeriosis physical examination#Endocarditis|Endocarditis]]
-====Vitals====
+==Febrile Gastroenteritis==
-=====Temperature=====
-*A [[fever]] is often present
-=====Pulse=====
+{| class="wikitable" style="border: 2; background: none;"
-======Rate======
+! colspan="1" rowspan="1" style="border: 1; background: 1;" |Organ System
-*[[Tachycardia]] may be present
+! colspan="1" rowspan="1" |Findings
-======Strength======
+|-
-*The pulse may be weak
+! rowspan="1" style="border: 1; background: none;" |General Appearance
-=====Blood Pressure=====
+|Patient is ill-looking
-*[[Hypotension]] may be present
+|-
-=====Respiratory Rate=====
+! rowspan="4" style="border: 1; background: none;" |Vital Signs
-*[[Tachypnea]] may be present
+|[[Fever]]
-===Skin===
+|-
-* [[Pallor]] may be present
+|[[Tachycardia]]
+|-
+|[[Tachypnea]]
+|-
+|[[Hypotension]]
+|-
+! style="border: 1; background: none;" |Skin
+|[[Pallor]]
+|-
+! style="border: 1; background: none;" |'''HEENT'''
+|Dry [[mucous membranes]]
+|-
+! rowspan="2" style="border: 1; background: none;" |Neurologic
+|[[Altered mental status]]
+|-
+|[[Focal neurologic signs|Motor and sensory focal neurologic signs]]
+|-
+! rowspan="2" style="border: 1; background: none;" |Abdominal
+|[[Abdominal tenderness]]
+|-
+|[[Abdominal distention]]
+|}
-<!--
+==Sepsis of Unknown Origin==
+{| class="wikitable" style="border: 2; background: none;"
+! colspan="1" rowspan="1" style="border: 1; background: 1;" |Organ System
+! colspan="1" rowspan="1" |Findings
+|-
+! rowspan="5" style="border: 1; background: none;" |Vital Signs
+|[[Fever]]
+|-
+|[[Tachycardia]]
+|-
+|[[Tachypnea]]
+|-
+|[[Hypotension]]
+|-
+|Weak peripheral [[pulses]]
+|-
+! rowspan="2" style="border: 1; background: none;" |Skin
+|[[Pallor]]
+|-
+|[[Cyanosis]]
+|-
+! rowspan="3" style="border: 1; background: none;" |'''HEENT'''
+|Dry [[mucous membranes]]
+|-
+|[[Lymphadenopathy]]
+|-
+|[[Papilledema]] on fundoscopic exam
+|-
+! rowspan="2" style="border: 1; background: none;" |Neurologic
+|[[Altered mental status]]
+|-
+|[[Focal neurologic signs|Motor and sensory focal neurologic signs]]
+|-
+! rowspan="1" style="border: 1; background: none;" |Abdominal
+|[[Abdominal tenderness]]
+|}
-* Lesions may be present
+==Central Nervous System Infection==
+{| class="wikitable" style="border: 2; background: none;"
-===Head===
+! colspan="1" rowspan="1" style="border: 1; background: 1;" |Organ System
-* Abnormalities of the head/hair may include ___
+! colspan="1" rowspan="1" |Findings
-* There may be evidence of trauma
+|-
+! rowspan="5" style="border: 1; background: none;" |Vital Signs
-===Eyes===
+|[[Fever]]
-*Icteric sclera may be present
+|-
-* [[Nystagmus]] may be present.
+|[[Tachycardia]]
-* Extra-ocular movements may be abnormal
+|-
-*Pupils may not react to light
+|[[Tachypnea]]
-*Ophthalmoscopic exam may be abnormal with findings of ___
+|-
+|[[Hypotension]]
-===Ears===
+|-
-* Hearing acuity may be reduced
+|Weak peripheral [[pulses]]
-*[[Weber test]] may be positive
+|-
-*[[Rinne test]] may be positive
+! rowspan="2" style="border: 1; background: none;" |Skin
-* There may be [[exudate]] from the ear canal
+|[[Pallor]]
-* There may be [[tenderness]] on movement of the pinnae
+|-
+|[[Skin rash]]
-===Nose===
+|-
-* Nares may be inflamed
+! rowspan="3" style="border: 1; background: none;" |'''HEENT'''
-* There may be [[epistaxis]]
+|Bulging [[fontanelles]] may be present ([[neonates]])
-* There may be [[purulent]] exudate from the nares
+|-
-* There may be [[tenderness]] to percussion of the sinuses
+|[[Papilledema]] on [[Fundoscopy|fundoscopic exam]]
-* The nares may be congested
+|-
+|[[Neck stiffness]] may be present (typically absent in [[neonates]])
-===Throat===
+|-
-* The throat may be erythematous
+! rowspan="6" style="border: 1; background: none;" |Neurologic
-* There may be [[exudate]] in the throat
+|[[Altered mental status]]
-* There may be [[petechiae]] seen in the throat
+|-
-* There may be tonsillar inflammation
+|[[Focal neurologic signs|Motor and sensory focal neurologic signs]]
+|-
-===Neck===
+|[[Autonomic dysfunction]] may be present
-*[[Jugular venous pressure]] may be elevated
+|-
-*[[Carotid bruits]] may be present
+|[[Hemiparesis]] may be present
-*[[Lymph nodes]] may be present
+|-
-*[[Thyromegaly]] may be present
+|[[Ataxia]] may be present
-*[[Hepatojugular reflux]] may be present
+|-
+|[[Dystonia]] may be present
-===Lungs===
+|}
-*[[Pulmonary edema]] and [[rales]] may be present
-*[[Wheezing]] may be present
-*Consolidation may be present with reduced breath sounds auscultated
-*[[Rales]] may be present
-*[[Egophony]] may be present
-* Chest movement may be assymetric
-===Heart===
-*A [[heave]] may be present
-*A [[thrill]] may be present
-*A [[friction rub]] may be pressent
-====Auscultation====
-*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
-*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
-*[[Heart sounds#Third heart sound S3|S3]]
-*[[Heart sounds#Fourth heart sound S4|S4]]
-*[[Heart sounds#Summation Gallop|Gallops]]
-*A [[systolic murmur]] best heard at the base may be present
-*A [[systolic murmur]] best heard at the apex may be present
-*A [[diastolic murmur]] may be present
-===Abdomen===
-*[[Abdominal distention]] may be present
-*[[Abdominal tenderness]] may be present
-*[[Rebound tenderness]] may be present
-*An [[acute abdomen]] may be present
-*An abdominal mass may be present
-*Guarding may be present
-*[[Hepatomegaly]] may be present
-*[[Splenomegaly]] may be present
-*Genitourinary exam if relevant
-===Extremities===
-*[[Clubbing]] may be present
-*[[Cyanosis]] may be present
-*[[Edema]] may be present
-===Neurologic===
-* Mental status may be altered
-* Glasgow coma scale is ___
-* Clonus may be present
-* Hyperactive reflexes may be present
-* There are deficits in cranial nerves ___
--->
 ==References==
 {{Reflist|2}}
-[[Category:Needs content]]
-[[Category:Bacterial diseases]]
-[[Category:Disease]]
-[[Category:Infectious disease]]
 {{WH}}
 {{WS}}
+[[Category:Emergency mdicine]]
+[[Category:Disease]]
+[[Category:Up-To-Date]]
+[[Category:Infectious disease]]
+[[Category:Neurology]]
+[[Category:Gastroenterology]]