• Patients are usually well-appearing in the absence of severe anemia.
• Patient appears ill in the state of septicemia.

• may have Tachycardia, depends on the severity of the anemia.
• may have Tachypnea depends on severity of the anemia.
• Patients may have weak pulse

• Jaundice
  • Secondary to hemolysis
• Pallor
  • Secondary to anemia

• may have signs of meningitis due to meningococcal infection following splenectomy : neck stiffness (redor) ,fever, headache

• Evidence of trauma
• Pale conjunctiva
• Scleral icterus

No specific sign.

• commonly normal lung sounds.
• May present crackle due to pneumococcal or Haemophilus influenza pneumonia , following splenectomy.

• commonly normal heart sounds

• Splenomegaly : the spleen can be palpable.
• Abdominal tenderness or fullness in the left upper quadrant following splenomegaly.
• Abdominal tenderness in the right upper quadrant due to biliary colic.
• Murphy’s sign that may suggest cholecystitis.

• Leg ulcers

• Patient is usually oriented to persons, place, and time
• Glasgow coma scale is normally 15 / 15 but may may present loss of consciousness in severe fatal hemorrhage episodes.^[1][2]