Brucellosis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin, mucous membranes and sclerae (white part of the eye).
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Auscultation (listening) of the heart.
    • Examination of the lungs
      • Auscultation (listening) of the lungs
      • Bronchophony (checking the transmission of high-frequency sounds; the patient is asked to pronounce the word “66” several times in a pointed voice while the physician listens to the lungs) [increased sound conduction due to pulmonary infiltration/compaction of lung tissue (e.g. in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (attenuated or absent): e.g., pleural effusion), the consequence is, the number “66” is barely audible over the diseased part of the lung to absent, because the high-frequency sounds are strongly attenuated]
      • Vocal fremitus (checking the transmission of low frequencies; the patient is asked to pronounce the word “99” several times in a low voice while the physician places his hands on the patient’s chest or back) [increased sound conduction due to pulmonary infiltration/compaction of lung tissue (e.g. e.g., in pneumonia), the consequence is, the number “99” is better understood on the diseased side than on the healthy side; strongly attenuated or absent: in pleural effusion), the consequence is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
    • Examination of the abdomen (abdomen)
      • Percussion (tapping) of the abdomen
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention? [Hepatosplenomegaly?]
        • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size [hepatosplenomegaly?]
      • Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
  • If necessary, neurological examination – if there is evidence of meningitis / meningitis.

Square brackets [ ] indicate possible pathological (pathological) physical findings.