Enterovirus 68 physical examination

• On physical examination, patients with EV-D68 infection generally develop typical signs of respiratory illness. The most common findings on physical exam include fever, tachypnea, skin rash, erythematous tonsils without exudates, and wheezing.

On physical examination, patients with EV-D68 infection may have signs of a mild to moderate acute upper respiratory tract infection.^{[1][2][3][4][5][6]}

• Fever is often present

• Tachycardia may be present

• Tachypnea may be present

• Maculo-papular rash
• Cyanosis (in severe cases)

• Nasal discharge
• Nasal flaring (neonates)

• Erythema and inflammation of the oropharynx, tonsils, and soft palate.
• Exudates are usually absent

• Wheezing (most common finding on pulmonary auscultation)
• Rhonchi
• Rales

• Abdominal tenderness may be present among patients who complain of abdominal pain or diarrhea

Acute flaccid myelitis may develop in cases of severe infection with EV-D68. The following findings may be found on physical examination:

• Motor loss on the affected side (Lower limbs > upper limbs)
• Decreased deep tendon reflexes
• Muscle atrophy on the affected side
• Reduced muscle tone