Symptoms of Respiratory infections
Symptoms of Respiratory infections
The list of signs and symptoms mentioned in various sources
for Respiratory infections includes the 17
symptoms listed below:
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Respiratory infections: Complications
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Respiratory infections Symptoms: Book Excerpts
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Respiratory infections: Medical Mistakes
Respiratory infections: Undiagnosed Conditions
Diseases that may be commonly undiagnosed in related medical areas:
Home Diagnostic Testing
Home medical tests related to Respiratory infections:
Wrongly Diagnosed with Respiratory infections?
The list of other diseases or medical conditions
that may be on the differential diagnosis list of alternative diagnoses
for Respiratory infections includes:
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alternative diagnoses for Respiratory infections
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More information about symptoms of Respiratory infections and related conditions:
Other Possible Causes of these Symptoms
Click on any of the symptoms below to see a full list
of other causes including diseases, medical conditions, toxins, drug interactions,
or drug side effect causes of that symptom.
Medical Books Online about Respiratory infections
Medical Books Excerpts
Excerpts of published medical book chapters related to Respiratory infections
are available from published medical books
for more detailed information about Respiratory infections.
Medical Books Excerpts
- COUGH
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Fever
- "In a Page: Signs and Symptoms" (2004)
- [ read ]
- COUGH
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- FEVER
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- Fever
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Cough
- "A Pocket Manual of Differential Diagnosis" (1999)
- [ read ]
- Lung cancer
- "Professional Guide to Diseases (Eighth Edition)" (2005)
- [ read ]
- Lassa fever
- "Professional Guide to Diseases (Eighth Edition)" (2005)
- [ read ]
- Cough
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Fever
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Cough, barking
- "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
- [ read ]
- Cough, productive
- "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
- [ read ]
- Fever
- "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
- [ read ]
- Fever
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Cough
- "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
- [ read ]
- Fever
- "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
- [ read ]
- Sore Throat
- "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
- [ read ]
- COUGH
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- FEVER
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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Patient Surveys for Respiratory infections
Symptoms of Respiratory infections: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the symptoms of Respiratory infections.
Acute respiratory failure in COPD:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
In patients who have COPD with ARF, increased ventilation-perfusion mismatch and reduced alveolar ventilation decrease PaO2 (hypoxemia) and increase Paco2 (hypercapnia). This rise in carbon dioxide (CO2) lowers the pH. The resulting hypoxemia and acidemia affect all body organs, especially the CNS and the respiratory and cardiovascular systems.
Specific symptoms vary with the underlying cause of ARF but may include these systems:
❑ Respiratory — Rate may be increased, decreased, or normal depending on the cause; respirations may be shallow, deep, or alternate between the two; and air hunger may occur. Cyanosis may or may not be present, depending on the hemoglobin (Hb) level and arterial oxygenation. Auscultation of the chest may reveal crackles, rhonchi, wheezing, or diminished breath sounds.
❑ CNS — When hypoxemia and hypercapnia occur, the patient may show evidence of restlessness, confusion, loss of concentration, irritability, tremulousness, diminished tendon reflexes, and papilledema; he may slip into a coma.
❑ Cardiovascular — Tachycardia, with increased cardiac output and mildly elevated blood pressure secondary to adrenal release of catecholamine, occurs early in response to low PaO2. With myocardial hypoxia, arrhythmias may develop. Pulmonary hypertension, secondary to pulmonary capillary vasoconstriction, may cause increased pressures on the right side of the heart, elevated jugular veins, an enlarged liver, and peripheral edema. Stresses on the heart may precipitate cardiac failure.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Infant respiratory distress syndrome:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
Although a neonate with IRDS may breathe normally at first, he usually develops rapid, shallow respirations within minutes or hours of birth, with intercostal, subcostal, or sternal retractions, nasal flaring, and audible expiratory grunting. This grunting is a natural compensatory mechanism designed to produce positive end-expiratory pressure (PEEP) and prevent further alveolar collapse.
Severe disease is marked by apnea, bradycardia, and cyanosis (from hypoxemia, left-to-right shunting through the foramen ovale, or right-to-left intrapulmonary shunting through atelectatic regions of the lung). Other clinical features include pallor, frothy sputum, and low body temperature as a result of an immature nervous system and the absence of subcutaneous fat.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Acute respiratory distress syndrome:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Rapid, shallow breathing; dyspnea, crackles, rhonchi; hypoxemia; bilateral infiltrates on chest X-ray
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Acute respiratory failure:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Shallow or deep respirations (or both), air hunger, cyanosis, adventitious breath sounds, confusion, decreased level of consciousness, tachycardia, pulmonary hypertension, irritability, decreased reflexes
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Respiratory acidosis:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Confusion, apprehension, asterixis, coma, headache, dyspnea, tachypnea, papilledema, depressed reflexes, tachycardia, hypertension or hypotension, arrhythmias, vasodilation
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Respiratory alkalosis:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Deep, rapid breathing; dizziness; agitation; circumoral and peripheral paresthesia; carpopedal spasms; twitching; muscle weakness; seizures; arrhythmias
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Respiratory syncytial virus infection:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
Clinical features of RSV infection vary in severity from mild, coldlike symptoms to bronchiolitis or bronchopneumonia and, in a few patients, severe, life-threatening lower respiratory tract infections. Symptoms usually include coughing, wheezing, malaise, pharyngitis, dyspnea, and inflamed mucous membranes in the nose and throat. Reinfection is common, producing milder symptoms than the primary infection.
Otitis media is a common complication of RSV in infants. RSV has also been identified in patients with a variety of central nervous system disorders, such as meningitis and myelitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Lung abscess:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Productive cough (purulent sputum), pleuritic chest pain, sweating, fever, chills, headache, malaise, weight loss
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Lung cancer:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
Because early-stage lung cancer usually produces no symptoms, this disease is usually in an advanced state at diagnosis. These late-stage symptoms commonly lead to diagnosis:
❑Epidermoid and small cell carcinomas — smoker's cough, hoarseness, wheezing, dyspnea, hemoptysis, and chest pain
❑ Adenocarcinoma and large cell carcinoma — fever, weakness, weight loss, anorexia, and shoulder pain.
In addition to their obvious interference with respiratory function, lung tumors may also alter the production of hormones that regulate body function or homeostasis. Clinical conditions that result from such changes are known as hormonal paraneoplastic syndromes:
❑ Gynecomastia may result from large cell carcinoma.
❑ Hypertrophic pulmonary osteoarthropathy (bone and joint pain from cartilage erosion due to abnormal production of growth hormone) may result from large cell carcinoma and adenocarcinoma.
❑ Cushing's and carcinoid syndromes may result from small cell carcinoma.
❑ Hypercalcemia may result from epidermoid tumors.
Metastatic signs and symptoms vary greatly, depending on the effect of tumors on intrathoracic and distant structures:
❑ bronchial obstruction: hemoptysis, atelectasis, pneumonitis, dyspnea
❑ cervical thoracic sympathetic nerve involvement: miosis, ptosis, exophthalmos, reduced sweating
❑ chest wall invasion: piercing chest pain, increasing dyspnea, severe shoulder pain, radiating down arm
❑ esophageal compression: dysphagia
❑ local lymphatic spread: cough, hemoptysis, stridor, pleural effusion
❑ pericardial involvement: pericardial effusion, tamponade, arrhythmias
❑ phrenic nerve involvement: dyspnea, shoulder pain, unilateral paralyzed diaphragm, with paradoxical motion
❑ recurrent nerve invasion: hoarseness, vocal cord paralysis
❑ vena caval obstruction: venous distention and edema of face, neck, chest, and back.
Distant metastasis may involve any part of the body, most commonly the central nervous system, liver, and bone.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Severe acute respiratory syndrome:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
The incubation period for SARS is typically 3 to 5 days but may last as long as 14 days. Initial signs and symptoms include fever, shortness of breath and other minor respiratory symptoms, general discomfort, headache, rigors, chills, myalgia, sore throat, and dry cough. Some individuals may develop diarrhea or a rash. Later complications include respiratory failure, liver failure, heart failure, myelodysplastic syndromes, and death.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Colorado tick fever:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
After a 3- to 6-day incubation period, Colorado tick fever begins abruptly with chills; temperature of 104° F (40° C); severe aching of back, arms, and legs; lethargy; and headache with eye movement such as extraocular movement. Photophobia, abdominal pain, nausea, and vomiting may occur. Rare effects include petechial or maculopapular rashes and central nervous system involvement. Symptoms subside after several days but return within 2 to 3 days and continue for 3 more days before slowly disappearing. Complete recovery usually follows.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Lassa fever:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
After a 7- to 18-day incubation period, this disease produces a fever that persists for 2 to 3 weeks, exudative pharyngitis, oral ulcers, lymphadenopathy with swelling of the face and neck, purpura, conjunctivitis, and bradycardia. Severe infection may also cause hepatitis, myocarditis, pleural infection, encephalitis, and permanent unilateral or bilateral deafness.
Virus multiplication in reticuloendothelial cells causes capillary lesions that lead to erythrocyte and platelet loss; mild to moderate thrombocytopenia (with a tendency toward bleeding); and secondary bacterial infection. These capillary lesions may also cause focal hemorrhage in the stomach, small intestine, kidneys, lungs, and brain and, possibly, hemorrhagic shock and peripheral vascular collapse.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Relapsing fever:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
The incubation period for relapsing fever is 5 to 15 days (the average is 7 days). Clinically, tick- and louse-borne diseases are similar. Both begin suddenly, with a temperature approaching 105° F (40.6° C), prostration, headache, severe myalgia, arthralgia, diarrhea, vomiting, coughing, and eye or chest pains. Splenomegaly is common; hepatomegaly and lymphade-nopathy may occur. During febrile periods, the victim's pulse and respiratory rates rise, and a transient macular rash may develop over his torso.
The first attack usually lasts from 3 to 6 days; then the patient's temperature drops quickly and is accompanied by profuse sweating. A skin rash on the trunk lasting 1 to 2 days is common after the primary febrile episode. The rash may be petechiae, macular, or papular. About 5 to 10 days later, a second febrile, symptomatic period begins. In louse-borne infection, additional relapses are unusual; but, in tick-borne cases, a second or third relapse is common. As the afebrile intervals become longer, relapses become shorter and milder because of antibody accumulation. Relapses are possibly due to antigenic changes in the Borrelia organism.
Complications from relapsing fever include nephritis, bronchitis, pneumonia, endocarditis, seizures, cranial nerve lesions, paralysis, and coma. Death may occur from hyperpyrexia, massive bleeding, circulatory failure, splenic rupture, or a secondary infection.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rheumatic fever and rheumatic heart disease:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
In 95% of patients, rheumatic fever characteristically follows a streptococcal infection that appeared a few days to 6 weeks earlier. A temperature of at least 100.4° F (38° C) occurs, and most patients complain of migratory joint pain or polyarthritis. Swelling, redness, and signs of effusion usually accompany such pain, which most commonly affects the knees, ankles, elbows, or hips. In 5% of patients (generally those with carditis), rheumatic fever causes skin lesions such as erythema marginatum, a nonpruritic, macular, transient rash that gives rise to red lesions with blanched centers. Rheumatic fever may also produce firm, movable, nontender, subcutaneous nodules about 3 mm to 2 cm in diameter, usually near tendons or bony prominences of joints (especially the elbows, knuckles, wrists, and knees) and less often on the scalp and backs of the hands. These nodules persist for a few days to several weeks and, like erythema marginatum, often accompany carditis.
Later, rheumatic fever may cause transient chorea, which develops up to 6 months after the original streptococcal infection. Mild chorea may produce hyperirritability, a deterioration in handwriting, or an inability to concentrate. Severe chorea (Sydenham’s chorea) causes purposeless, nonrepetitive, involuntary muscle spasms; poor muscle coordination; and weakness. Chorea always resolves without residual neurologic damage.
The most destructive effect of rheumatic fever is carditis, which develops in up to 50% of patients and may affect the endocardium, myocardium, pericardium, or the heart valves. Pericarditis causes a pericardial friction rub and, occasionally, pain and effusion. Myocarditis produces characteristic lesions called Aschoff bodies (in the acute stages) and cellular swelling and fragmentation of interstitial collagen, leading to formation of a progressively fibrotic nodule and interstitial scars. Endocarditis causes valve leaflet swelling, erosion along the lines of leaflet closure, and blood, platelet, and fibrin deposits, which form beadlike vegetations. Endocarditis affects the mitral valve most often in females; the aortic, most often in males. In both females and males, endocarditis affects the tricuspid valves occasionally and the pulmonic only rarely.
Severe rheumatic carditis may cause heart failure with dyspnea; right upper quadrant pain; tachycardia; tachypnea; a hacking, nonproductive cough; edema; and significant mitral and aortic murmurs. The most common of such murmurs include:
❑ a systolic murmur of mitral insufficiency (high-pitched, blowing, holosystolic, loudest at apex, possibly radiating to the anterior axillary line)
❑ a midsystolic murmur due to stiffening and swelling of the mitral leaflet
❑ occasionally, a diastolic murmur of aortic insufficiency (low-pitched, rumbling, almost inaudible). Valvular disease may eventually result in chronic valvular stenosis and insufficiency, including mitral stenosis and insufficiency, and aortic insufficiency. In children, mitral insufficiency remains the major sequela of rheumatic heart disease.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Acute respiratory failure in COPD:
Signs and symptoms
(Handbook of Diseases)
In COPD patients with ARF, increased ventilation-perfusion mismatching and reduced alveolar ventilation decrease Pao2 (hypoxemia) and increase Paco2 (hypercapnia). This rise in carbon dioxide tension lowers the pH. The resulting hypoxemia and acidemia affect all body organs, especially the central nervous, respiratory, and cardiovascular systems. Specific symptoms vary with the underlying cause of ARF but can include any of the following:
Respiratory symptoms. The respiratory rate may be increased, decreased, or normal, depending on the cause; respirations may be shallow or deep, or they may alternate between the two; and air hunger may occur. Cyanosis may or may not be present, depending on the hemoglobin (Hb) level and arterial oxygenation. Auscultation of the chest may reveal crackles, rhonchi, wheezes, or diminished breath sounds.
CNS symptoms. The patient may show evidence of restlessness, confusion, loss of concentration, irritability, tremulousness, diminished tendon reflexes, and papilledema; he may slip into a coma.
Cardiovascular symptoms. Tachycardia, with increased cardiac output and mildly elevated blood pressure secondary to adrenal release of catecholamines, occurs early in response to a low Pao2.With myocardial hypoxia, arrhythmias may develop. Pulmonary hypertension also occurs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Respiratory acidosis:
Signs and symptoms
(Handbook of Diseases)
Acute respiratory acidosis produces CNS disturbances that reflect changes in the pH of cerebrospinal fluid rather than increased carbon dioxide levels in cerebral circulation.
Effects range from restlessness, confusion, and apprehension to somnolence, with a fine or flapping tremor (asterixis), or coma. The patient may complain of headaches and exhibit dyspnea and tachypnea with papilledema and depressed reflexes. Unless the patient is receiving oxygen, hypoxemia accompanies respiratory acidosis.
This disorder may also cause cardiovascular abnormalities, such as tachycardia, hypertension, atrial and ventricular arrhythmias and, in severe acidosis, hypotension with vasodilation (bounding pulses and warm periphery).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Respiratory alkalosis:
Signs and symptoms
(Handbook of Diseases)
The cardinal sign of respiratory alkalosis is deep, rapid breathing, possibly exceeding 40 breaths/minute and much like the Kussmaul’s respirations that characterize diabetic acidosis.
Such hyperventilation usually leads to CNS and neuromuscular disturbances, such as light-headedness or dizziness (from below-normal carbon dioxide levels that decrease cerebral blood flow), agitation, circumoral and peripheral paresthesia, carpopedal spasms, twitching (possibly progressing to tetany), and muscle weakness. Severe respiratory alkalosis may cause cardiac arrhythmias that fail to respond to conventional treatment, seizures, or both.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Respiratory distress syndrome:
Signs and symptoms
(Handbook of Diseases)
Although a neonate with respiratory distress syndrome may breathe normally at first, he usually develops rapid, shallow respirations within minutes or hours of birth, with intercostal, subcostal, or sternal retractions; nasal flaring; and audible expiratory grunting. This grunting is a natural compensatory mechanism designed to produce positive end-expiratory pressure (PEEP) and prevent further alveolar collapse.
The neonate may also display hypotension, peripheral edema, and oliguria; if he has severe disease, apnea, bradycardia, and cyanosis (from hypoxemia, left-to-right shunting through the foramen ovale, or right-to-left shunting through atelectatic regions of the lung) may be present. Other signs and symptoms include pallor, frothy sputum, and low body temperature as a result of an immature nervous system and the absence of subcutaneous fat.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Respiratory syncytial virus infection:
Signs and symptoms
(Handbook of Diseases)
Signs and symptoms of RSV infection vary in severity, ranging from mild coldlike symptoms to bronchiolitis or bronchopneumonia and, in a few patients, severe, life-threatening lower respiratory tract infections. Generally, signs and symptoms include coughing, wheezing, malaise, pharyngitis, dyspnea, and inflamed mucous membranes in the nose and throat.
Otitis media is a common complication of RSV in infants. RSV has also been identified in patients with various central nervous system disorders, such as meningitis and myelitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Lung abscess:
Signs and symptoms
(Handbook of Diseases)
Signs and symptoms of lung abscess include a cough that may produce bloody, purulent, or foul-smelling sputum; pleuritic chest pain; dyspnea; excessive sweating; chills; fever; headache; malaise; diaphoresis; and weight loss.
Complications include rupture into the pleural space, which results in empyema and, rarely, massive hemorrhage. A chronic lung abscess may cause localized bronchiectasis. Failure of an abscess to improve with antibiotic treatment suggests a possible underlying neoplasm or another cause of obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Lung cancer:
Signs and symptoms
(Handbook of Diseases)
Because early-stage lung cancer usually produces no symptoms, this disease is typically in an advanced state at diagnosis. The following late-stage signs and symptoms commonly lead to a diagnosis:
❑ with epidermoid and small cell carcinomas: smoker’s cough, hoarseness, wheezing, dyspnea, hemoptysis, and chest pain
❑ with adenocarcinoma and large cell carcinoma: fever, weakness, weight loss, anorexia, and shoulder pain.
Besides their obvious interference with respiratory function, lung tumors may also alter the production of hormones that regulate body function or homeostasis. Clinical conditions that result from such changes are known as hormonal paraneoplastic syndromes:
❑ Gynecomastia may result from large cell carcinoma.
❑ Hypertrophic pulmonary osteoarthropathy (bone and joint pain from cartilage erosion due to abnormal production of growth hormone) may result from large cell carcinoma or adenocarcinoma.
❑ Cushing’s and carcinoid syndromes may result from small cell carcinoma.
❑ Hypercalcemia may result from epidermoid tumors.
Metastatic signs and symptoms vary greatly, depending on the effect of tumors on intrathoracic and distant structures:
❑ bronchial obstruction: hemoptysis, atelectasis, pneumonitis, and dyspnea
❑ recurrent nerve invasion: hoarseness and vocal cord paralysis
❑ chest wall invasion: piercing chest pain; increasing dyspnea; and severe shoulder pain, radiating down the arm
❑ local lymphatic spread: cough, hemoptysis, stridor, and pleural effusion
❑ phrenic nerve involvement: dyspnea; shoulder pain; and unilateral paralyzed diaphragm, with paradoxical motion
❑ esophageal compression: dysphagia
❑ vena caval obstruction: venous distention and edema of the face, neck, chest, or back
❑ pericardial involvement: pericardial effusion, tamponade, and arrhythmias
❑ cervical thoracic sympathetic nerve involvement: miosis, ptosis, exophthalmos, and reduced sweating.
Distant metastasis may involve any part of the body, most commonly the central nervous system, liver, and bone.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Rheumatic fever and rheumatic heart disease:
Signs and symptoms
(Handbook of Diseases)
In 95% of patients, rheumatic fever characteristically follows a streptococcal infection that appeared a few days to 6 weeks earlier. A temperature of at least 100.4° F (38° C) occurs.
Joint pain
Most patients complain of migratory joint pain or polyarthritis. Swelling, redness, and signs of effusion usually accompany such pain, which most commonly affects the knees, ankles, elbows, or hips.
Skin lesions and nodules
In 5% of patients (generally those with carditis), rheumatic fever causes skin lesions, such as erythema marginatum. This nonpruritic, macular, transient rash gives rise to red lesions with blanched centers.
Rheumatic fever may also produce firm, movable, nontender, subcutaneous nodules ⅛" to ¾" (0.5 to 2 cm) in diameter, usually near tendons or bony prominences of joints (especially the elbows, knuckles, wrists, and knees) and less commonly on the scalp and backs of the hands. These nodules persist for a few days to several weeks and, like erythema marginatum, often accompany carditis.
Chorea
Later, rheumatic fever may cause transient chorea, which develops up to 6 months after the original streptococcal infection.
Mild chorea may produce hyperirritability, a deterioration in handwriting, or an inability to concentrate. Severe chorea causes purposeless, nonrepetitive, involuntary muscle spasms; poor muscle coordination; and weakness. Chorea always resolves without residual neurologic damage.
Carditis
The most destructive effect of rheumatic fever is carditis, which develops in up to 50% of patients. It may affect the endocardium, myocardium, pericardium, or the heart valves.
Pericarditis causes a pericardial friction rub and, occasionally, pain and effusion. Myocarditis produces characteristic lesions called Aschoff bodies (in the acute stages) and cellular swelling and fragmentation of interstitial collagen, leading to formation of a progressively fibrotic nodule and interstitial scars.
Endocarditis causes valve leaflet swelling, erosion along the lines of leaflet closure, and blood, platelet, and fibrin deposits, which form beadlike vegetations. Endocarditis usually affects the mitral valve in females and the aortic valve in males. In both sexes, endocarditis affects the tricuspid valves occasionally and the pulmonic valve only rarely.
Severe rheumatic carditis may cause heart failure with dyspnea, right-upper-quadrant pain, tachycardia, tachypnea, significant mitral and aortic murmurs, and a hacking, nonproductive cough.
The most common murmurs include:
❑ a systolic murmur of mitral insufficiency (high-pitched, blowing, holo-systolic, loudest at apex, possibly radiating to the anterior axillary line)
❑ a midsystolic murmur caused by stiffening and swelling of the mitral leaflet
❑ occasionally, a diastolic murmur of aortic insufficiency. Valvular disease may eventually result in chronic valvular stenosis and insufficiency, including mitral stenosis and insufficiency and aortic insufficiency. In children, mitral insufficiency remains the major after-effect of rheumatic heart disease.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Medical articles and books on symptoms:
These general reference articles may be of interest
in relation to medical signs and symptoms of disease in general:
Full list of premium articles on symptoms and diagnosis
About signs and symptoms of Respiratory infections:
The symptom information on this page
attempts to provide a list of some possible signs and symptoms of Respiratory infections.
This signs and symptoms information for Respiratory infections has been gathered from various sources,
may not be fully accurate,
and may not be the full list of Respiratory infections signs or Respiratory infections symptoms.
Furthermore, signs and symptoms of Respiratory infections may vary on an individual basis for each patient.
Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they
are indeed Respiratory infections symptoms.
Allergies can leave children feeling sniffly, teary and itchy and take their toll at play and at school. Previously, allergy remedies left children...
When you have watery eyes, a runny nose, congestion and sneezing, how can you tell if it's a cold or an allergy? Find out the difference and the...
"I authorize the release of any medical or other information necessary to process this claim." Do you recognize these words? You should, if...
Stress takes its toll by making us anxious, depressed and not able to function as fully as we'd like. What many don't know is that stress can...
See full list of 4 related videos
» Next page: Diagnostic Tests for Respiratory infections
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