Cytomegaly: 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; further:
  • Inspection (viewing).
    • Skin, mucous membranes, pharynx (throat), sclerae (white part of the eye), and lymph node stations [due tosymptoms:
      • In prenatal infection: jaundice (jaundice), exanthema (skin rash), petechiae (skin bleeding), lymphadenopathy (lymph node enlargement).
      • In peri- and postnatal infection: pharyngitis (inflammation of the throat), lymphadenitis (inflammation of the lymph nodes with lymph node enlargement), parotitis (inflammation of the salivary glands)]
    • 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 [due topossible sequelae in postnatal infection: myocarditis (inflammation of the heart muscle)].
  • Examination of the lungs (due topossible sequelae).
    • Auscultation (listening) of the lungs [tachypnea (breathing too fast)]
    • 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 decreased 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]
  • Examination of the abdomen (abdomen) [due tosymptoms: in prenatal infection: hepatosplenomegaly (liver and spleen enlargement); in peri- and postnatal infection: hepatitis (liver inflammation)]
    • Percussion (palpation) of the abdomen.
      • Meteorism (flatulence): hypersonoric tapping sound.
      • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
      • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
    • Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
• If necessary, ophthalmological examination[due tosymptoms:
  • In the case of prenatal infection: chorioretinitis (inflammation of the choroid (choroid) with involvement of the retina (retina)).
  • In peri- and postnatal infection: panuveitis (inflammation of the medial uvea), retinitis (CMV retinitis) (retinal inflammation)]

  [due toPossible sequelae:

  • Amaurosis (blindness)
  • Cataract (clouding of the lens) – as a result of CMV retinitis (retinitis caused by cytomegalovirus).
  • Microphthalmos (eyeball too small)]
• Gynecological examination in existing pregnancy [due topossible sequelae: miscarriage].
• Neurological examination [due topossible sequelae: meningoencephalitis (combined inflammation of the brain (encephalitis) and meninges (meningitis))]

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