Ebola physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
The general appearance of the patient will depend on the stage of evolution of the disease. However, common presentations include a patient who shows | The general appearance of the patient will depend on the stage of evolution of the disease. However, common presentations include a patient who shows [[prostration]], who may be [[nauseated]] and [[vomiting]], with [[shortness of breath|difficult in breathing]] and in [[dysphagia|swallowing]] and possibly showing some kind of [[hemorrhage]], most typically [[retinal]] [[hemorrhage]] and/or [[bleeding gums]].<ref name="BorchertMutyaba2011">{{cite journal|last1=Borchert|first1=Matthias|last2=Mutyaba|first2=Imaam|last3=Van Kerkhove|first3=Maria D|last4=Lutwama|first4=Julius|last5=Luwaga|first5=Henry|last6=Bisoborwa|first6=Geoffrey|last7=Turyagaruka|first7=John|last8=Pirard|first8=Patricia|last9=Ndayimirije|first9=Nestor|last10=Roddy|first10=Paul|last11=Van der Stuyft|first11=Patrick|title=Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned|journal=BMC Infectious Diseases|volume=11|issue=1|year=2011|pages=357|issn=1471-2334|doi=10.1186/1471-2334-11-357}}</ref> | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
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====Respiratory Rate==== | ====Respiratory Rate==== | ||
*Signs of respiratory difficulty may be present, such as [[intercostal]] retractions, paradoxical [[breathing]] and [[nasal]] flare. | |||
*[[Tachypneic]]: Many fatal cases presented with [[tachypnea]] and no survivors had tachypnea | *[[Tachypneic]]: Many fatal cases presented with [[tachypnea]] and no survivors had tachypnea | ||
Revision as of 02:43, 24 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]; João André Alves Silva, M.D. [3]
Overview
Despite the existence of different species of Ebola virus, according to the data collected throughout the last 40 years, a common clinical syndrome has been described among these different filoviroses, with the difference residing essentially in the severity of the presentation and respective mortality rate. Attending to the mechanism of infection and pathogeny of the virus in human cells, Ebola hemorrhagic fever usually begins with an acute onset of high fever, chills and hemorrhage observed on physical examination. Other pertinent findings may include swollen joints, weakness, rash and red eyes. Also, the high fever present in this condition may lead to the development of relative bradycardia, similarly to typhoid fever. [1][2][3]
Physical Examination
The general appearance of the patient will depend on the stage of evolution of the disease. However, common presentations include a patient who shows prostration, who may be nauseated and vomiting, with difficult in breathing and in swallowing and possibly showing some kind of hemorrhage, most typically retinal hemorrhage and/or bleeding gums.[4]
Appearance of the Patient
Vitals
Temperature
- High fever
Pulse
Rate
Rhythm
- The pulse is regular.
Strength
- The pulse may be weak in cases of dehydration and hemorrhage.
Symmetry
- The pulses are symmetric.
Blood Pressure
- Hypotension (less than 90 mm Hg of SBP and 60 mm Hg of DBP)
- Postural hypotension
Respiratory Rate
- Signs of respiratory difficulty may be present, such as intercostal retractions, paradoxical breathing and nasal flare.
- Tachypneic: Many fatal cases presented with tachypnea and no survivors had tachypnea
Skin
- Maculopapular rash on the trunk associated with erythema and desquamation
- Petechiae
- Ecchymoses
- Mucosal hemorrhages
Eyes
Nose
Throat
- Mucosal hyperemia of the oral cavity
- Bleeding gums
Abdomen
Extremities
- Edema may be present
Neurologic
References
- ↑ Feldmann, Heinz; Geisbert, Thomas W (2011). "Ebola haemorrhagic fever". The Lancet. 377 (9768): 849–862. doi:10.1016/S0140-6736(10)60667-8. ISSN 0140-6736.
- ↑ Formenty, Pierre; Hatz, Christophe; Le Guenno, Bernard; Stoll, Agnés; Rogenmoser, Philipp; Widmer, Andreas (1999). "Human Infection Due to Ebola Virus, Subtype Côte d'Ivoire: Clinical and Biologic Presentation". The Journal of Infectious Diseases. 179 (s1): S48–S53. doi:10.1086/514285. ISSN 0022-1899.
- ↑ Gradon J (2000). "An outbreak of Ebola virus: lessons for everyday activities in the intensive care unit". Crit Care Med. 28 (1): 284–5. PMID 10667555.
- ↑ Borchert, Matthias; Mutyaba, Imaam; Van Kerkhove, Maria D; Lutwama, Julius; Luwaga, Henry; Bisoborwa, Geoffrey; Turyagaruka, John; Pirard, Patricia; Ndayimirije, Nestor; Roddy, Paul; Van der Stuyft, Patrick (2011). "Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned". BMC Infectious Diseases. 11 (1): 357. doi:10.1186/1471-2334-11-357. ISSN 1471-2334.
- ↑ Ndambi R, Akamituna P, Bonnet MJ, Tukadila AM, Muyembe-Tamfum JJ, Colebunders R (1999). "Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995". J Infect Dis. 179 Suppl 1: S8–10. doi:10.1086/514297. PMID 9988156.
- ↑ Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y; et al. (1999). "Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients". J Infect Dis. 179 Suppl 1: S1–7. doi:10.1086/514308. PMID 9988155.
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.