Meningitis physical examination: Difference between revisions
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{{Meningitis}} | {{Meningitis}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}} | {{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}, {{JH}}. | ||
==Physical Examination== | ==Physical Examination== | ||
Meningitis is a [[medical emergency]], and referral to hospital is indicated. | Meningitis is a [[medical emergency]], and referral to a hospital is indicated. | ||
===Skin=== | ===Skin=== | ||
Rapidly-spreading [[petechial rash]] is typical in "meningococcal" meningitis , and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet. | Rapidly-spreading [[petechial rash]] is typical in "meningococcal" meningitis, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet. | ||
===Gallery=== | |||
====Trunk==== | |||
<gallery> | |||
Image: Meningitis_01.png| Meningitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=287}}</ref></small></small> | |||
Image: Meningitis_02.jpg| Meningititis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=287}} </ref>></small></small> | |||
</gallery> | |||
====Extremities==== | |||
<gallery> | |||
Image: Meningitis_03.jpeg| Meningitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=287}} </ref></small></small> | |||
</gallery> | |||
===Neurologic=== | ===Neurologic=== | ||
* Nuchal rigidity is typically assessed with the patient lying [[Supine position|supine]] | * Nuchal rigidity is typically assessed with the patient lying [[Supine position|supine]]. | ||
* [[Kernig's sign]]: Pain is elicited when the knees are passively extended | * [[Kernig's sign]]: Pain is elicited when the knees are passively extended . | ||
* [[Brudzinski's sign]] | * [[Brudzinski's sign]]: In infants, forward flexion of the neck may cause involuntary knee and hip flexion. Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.<ref name=Thomas_2002>{{cite journal |author=Thomas KE, Hasbun R, Jekel J, Quagliarello VJ |title=The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis |journal=Clin. Infect. Dis. |volume=35 |issue=1 |pages=46-52 |year=2002 |pmid=12060874 |doi=}}</ref> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
| Line 26: | Line 47: | ||
[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Neurological disorders]] | [[Category:Neurological disorders]] | ||
Latest revision as of 22:42, 29 July 2020
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Meningitis Main Page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Jesus Rosario Hernandez, M.D. [3].
Physical Examination
Meningitis is a medical emergency, and referral to a hospital is indicated.
Skin
Rapidly-spreading petechial rash is typical in "meningococcal" meningitis, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet.
Gallery
Trunk
-
![Meningitis. With permission from Dermatology Atlas.[1]](/images/1/15/Meningitis_01.png)
Meningitis. With permission from Dermatology Atlas.[1]
-
![Meningititis. With permission from Dermatology Atlas.[1]>](/images/d/d7/Meningitis_02.jpg)
Meningititis. With permission from Dermatology Atlas.[1]>
![Meningitis. With permission from Dermatology Atlas.[1]](/index.php/File:Meningitis_01.png)
![Meningititis. With permission from Dermatology Atlas.[1]>](/index.php/File:Meningitis_02.jpg)
Extremities
-
![Meningitis. With permission from Dermatology Atlas.[1]](/images/5/54/Meningitis_03.jpeg)
Meningitis. With permission from Dermatology Atlas.[1]
![Meningitis. With permission from Dermatology Atlas.[1]](/index.php/File:Meningitis_03.jpeg)
Neurologic
- Nuchal rigidity is typically assessed with the patient lying supine.
- Kernig's sign: Pain is elicited when the knees are passively extended .
- Brudzinski's sign: In infants, forward flexion of the neck may cause involuntary knee and hip flexion. Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.[2]