Chills: Examination

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

  • General physical examination – including blood pressure, pulse, temperature measurement (preferably repeatedly rectally – in the anus), body weight, height; furthermore:
    • Inspection (viewing).
      • Skin, mucous membranes and sclerae (white part of the eye).
    • Auscultation (listening) of the heart [due todifferential diagnosis: infective endocarditis (endocarditis)].
    • Examination of the lungs
      • Auscultation of the lungs [due todifferential diagnoses: bronchitis (inflammation of the bronchial mucosa), pneumonia (inflammation 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 the lung tissue (e.g. e.g. in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in case of decreased sound conduction (attenuated or absent: e.g. in pleural effusion, pneumothorax, emphysema). 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]
      • Vocal fremitus (checking the conduction 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; in case of reduced sound conduction (attenuated: e.g. atelectasis, pleural rind; strongly attenuated or absent: in case of pleural effusion, pneumothorax, pulmonary emphysema). The result 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) etc. [due todifferential diagnosis: appendicitis (appendicitis)]
    • Palpation and tapping of the renal bearings [due todifferential diagnosis: pyelonephritis (inflammation of the renal pelvis)]
    • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation.
  • If necessary, ENT medical examination [due todifferential diagnoses: otitis media (otitis media), sinusitis (sinusitis), tonsillitis (tonsillitis)].
  • If necessary, neurological examination [due todifferential diagnosis: meningitis (meningitis)]

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