Chlamydia: Examination

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

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, sclerae (white part of the eye), abdominal wall and inguinal region (groin area).
    • Examination of the lungs (due topossible sequelae):
      • Auscultation 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 several times in a low voice the word “99”, 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]
  • Gynecological examination
    • Inspection
      • Vulva (external, primary female sex organs) [itching, burning during urination].
      • Vagina (vaginal) [increased vaginal discharge, itching]
    • Palpation (bimanual; palpation with both hands) of the internal genital organs.
      • Uterus (uterus) [Normal: anteflexed/angled forward, normal size, no tenderness] [due topossible sequelae: endometritis (inflammation of the uterus)].
      • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tube (fallopian tube)). [Normal: free] [due topossible secondary disease: adnexitis (inflammation of the fallopian tubes)]
      • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
      • Pelvic walls [Normal: free] [due topossible sequelae: pelveoperitonitis (peritonitis in the small pelvis)]
    • [due tocause: hormonal contraceptives (contraceptives)?]
  • Urological examination
    • Inspection and palpation of the abdomen (belly), inguinal region (groin region), etc.
    • Inspection and palpation of the genitals (penis and scrotum (scrotum); assessment of pubescence (pubic hair), penis (penis length: between 7-10 cm when flaccid; presence of: Indurations (hardening of tissue), anomalies, phimosis/foreskin stenosis?) as well as the position and size of the testicles (if necessary, using an orchimeter); if necessary, the painfulness compared to the opposite side or where is the punctum maximum of the pain) [in men: urethritis (inflammation of the urethra) with symptoms such as a strong urge to urinate, pulling pain, mucopurulent discharge, itching, burning during urination; in women: Urethritis] [due todifferential diagnoses:
    • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation (assessment of the prostate in size, shape and consistency, detection of indurations (hardening of tissue) if necessary). [Proctitis (rectal inflammation)]
  • Ophthalmologic examination [due topossible sequelae: Amaurosis (blindness); clouding of the cornea; corneal scarring)]

In square brackets [ ] is referred to possible pathological (pathological) physical findings.