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) [leading symptom: itchy exanthema (rash) with papules, vesicles, and crusts that are in various stages of development (starry sky); usually occurs first on the face and trunk of the body, then later over the entire body, including mucous membranes]
- Auscultation (listening) of the heart [due topossible secondary disease: myocarditis (inflammation of the heart muscle)]
- Examination of the lungs (due topossible sequelae).
- 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 doctor 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., in pleural effusion). The result is, the number “66” is barely audible to absent over the diseased part of the lung, because the high-frequency sounds are strongly attenuated]
- Voice fremitus (checking the transmission of low frequencies; the patient is asked to say the word “99” several times in a low voice, while the doctor puts his hands on the chest or back of the patient)[increased sound conduction due to pulmonary infiltration / compaction of lung tissue (eg, in pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (greatly 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]
- Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection (viewing).
- Gynecological examination in existing pregnancy [due topossible sequelae:
- Abortion (miscarriage)
- Fetal varicella syndrome (clinical picture characterized by neurological disorders, skin changes, eye disorders, and bone abnormalities; occurs when the mother becomes ill in the first and second trimester/third trimester of pregnancy)
- Severe courses of varicella infection in newborns whose mother contracted varicella shortly before birth (within five days before birth)]
- Neurological examination [due topossible sequelae:
- Encephalitis (inflammation of the brain).
- Guillain-Barré syndrome (GBS; synonyms: Idiopathic polyradiculoneuritis, Landry-Guillain-Barré-Strohl syndrome); two courses: acute inflammatory demyelinating polyneuropathy or chronic inflammatory demyelinating polyneuropathy (disease of the peripheral nervous system); idiopathic polyneuritis (diseases of multiple nerves) of spinal nerve roots and peripheral nerves with ascending paralysis and pain; usually occurs after infections.
- Meningitis (meningitis).
- Myelitis transversa (diffuse inflammation of the spinal cord).
- Reye syndrome (acute encephalopathy (pathological change of the brain) with concomitant fatty liver hepatitis (fatty liver inflammation) after a passed viral infection in young children; occurs on average one week after the resolution of the previous illness).
- Cerebellar ataxia (gait unsteadiness due to cerebellar dysfunction)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
