Whipple’s Disease: 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, and sclerae (white part of the eye) [disorders in skin pigmentation; uveitis (inflammation of the middle skin of the eye)]
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
      • Extremities [polyarthritis (inflammation of multiple joints)]
    • Inspection and palpation (palpation) of lymph node stations [lymphadenitis (inflammation of lymph nodes)]
    • Auscultation (listening) of the heart [due topossible symptom or secondary disease: pericarditis (pericarditis)][due todifferential diagnosis: endocarditis (pericarditis)]
    • Auscultation of the lungs
    • Examination of the abdomen (belly)
      • Percussion (tapping) 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 (abdominal) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain? [Abdominal pain (abdominal pain)? ]
  • If necessary, ophthalmological examination [due topossible secondary disease: uveitis (inflammation of the middle eye skin)].
  • Neurological examination [due topossible neurological symptoms with amnesia (memory loss), dementia, gaze paralysis, epilepsy (seizures), gait disturbances, disturbed sleep-wake rhythm, polydipsia (abnormally increased water intake; more than 4 liters of fluid intake per day)][due todifferential diagnosis: dementia][due topossible sequelae:
    • Amnesia (memory loss)
    • Ataxia (gait disturbance)
    • Gaze paralysis
    • Dementia
    • Epilepsy (seizures)
    • Disturbed sleep-wake rhythm]
  • If necessary, orthopedic/rheumatological examination [due topossible secondary diseases:
    • Polyarthritis (inflammation of multiple joints).
    • Synovitis (inflammation of the synovial membrane)]

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