Middle East respiratory syndrome coronavirus infection physical examination

Patients with MERS-CoV infection typically present with vital signs derangement, such as high-grade fever, tachycardia, tachypnea, and decreased oxygen saturation. Signs on physical examination may include decreased breath sounds, crackles, dullness on percussion, and increased tactile fremitus on pulmonary auscultation. Signs of complications may also be present, such as profound hypotension (suggestive of shock) or pericardial rub (suggestive of pericarditis).^[1][2][3]

Typical signs on physical examination for MERS-CoV primary infection are shown below. Additionally, signs for MERS-CoV-associated complications may also be present.

• Hospitalized patients are usually sick-looking and may be in a critically ill condition.^[3][4]

• Hypotension
• Tachycardia
• Tachypnea
• Fever (typically high-grade)
• Decreased oxygen saturation

• Tonsillar swelling

• Stridor
• Decreased breath sounds
• Crackles, rhonchi, wheezing on pulmonary auscultation
• Dullness on thoracic percussion
• Increased tactile fremitus
• High intensity egophony

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