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), and sclera (white part of the eye) [erythema migrans (migratory redness; circular redness around the site of the bite usually with a light border and central lightening; can also occur on other parts of the body!; as it progresses, the erythema fades from the center, so that the initially disk-shaped redness is later seen as a ring-shaped redness. Emergence: days to about 10 weeks after the tick bite); conjunctivitis (conjunctivitis); pharyngitis (pharyngitis)]
- Inspection and palpation (palpation) of the musculoskeletal system [mono- or asymmetric oligoarthritides of the large joints (occurrence of joint inflammation (arthritis) in fewer than 5 joints); chronic enthesitides (inflammation of tendons and ligaments)]
- Auscultation of the heart [due topossible sequelae: arrhythmias / cardiac arrhythmias].
- Palpation of the abdomen (belly), etc., with an attempt to palpate the liver and spleen [splenomegaly (splenomegaly)?; inspection of the skin with palpation of lymph node stations]
- Inspection (viewing).
- If necessary, ophthalmological examination [due topossible sequelae: Iritis (iris); conjunctivitis (conjunctivitis); temporary blindness in children due to pressure on the optic nerve (optic nerve)].
- If necessary, neurological examination – including testing for meningismus (painful neck stiffness), checking motor and sensory function [due tosecondary diseases:
- Ataxia (gait disturbances).
- Chronic encephalomyelitis (inflammation of the brain and spinal cord with paresis (paralysis)).
- Encephalitis (inflammation of the brain)
- Encephalopathy (brain changes that can lead to memory impairment, sleep disturbances and mood disorders, among others).
- Facial paresis (paralysis of the facial nerve with the corner of the mouth hanging down on one side).
- Meningitis (meningitis)
- Myelitis (inflammation of the spinal cord)
- Neuritis (inflammation of the nerves)
- Neuropathy (nerve damage)
- Pain due to polyneuropathy (disease of the nerves of the peripheral nervous system; depending on the cause, motor, sensory or autonomic nerves may be affected; sensitivity disorders)]
- Orthopedic examination – if arthropathy (disease of the joints) is suspected, with measurement of the range of motion of the joints.
Square brackets [ ] indicate possible pathological (pathological) physical findings.
