Neutropenia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Daniel A. Gerber, M.D. [2]

Physical examination should focus on identifying any potential signs of infection and is directed by the patients’ presenting symptoms. A rectal examination should not be performed in a patient with neutropenia.

A rectal examination should not be performed in a patient with neutropenia.^[1]

Vital signs

• Fever
• Tachycardia
• Hypotension
• Tachypnea
• Hypoxia

General appearance

• Signs of distress
• Localizing sources of pain
• Conjunctival and palatal pallor
• Petechiae or purpura
• Mucositis or other oropharyngeal lesions
• Lymphadenopathy

Neurological exam

• Confusion or disorientation
• Neck stiffness
• Focal neurological abnormalities

Chest

• New heart murmurs
• Wheezes, rales, rhonchorous breath sounds

Abdomen

• Abdominal pain
• distension
• Hepatomegaly or Splenomegaly

Extremities

• Joint swelling or deformity
• Rashes