Meningitis history and symptoms: Difference between revisions
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{{Meningitis}} | {{Meningitis}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}, {{KD}} | |||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}} | |||
==Overview== | ==Overview== | ||
Patients with meningitis had the classic triad of [[fever]], [[nuchal rigidity]] and [[mental status|change in mental status]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
In the study by Durand et.al., only 2/3 of patients had the classic triad of [[fever]], [[nuchal rigidity]] and [[mental status|change in mental status]]. | In the study by Durand et.al., only 2/3 of patients had the classic triad of [[fever]], [[nuchal rigidity]] and [[mental status|change in mental status]]. | ||
* All patients, however, had at least one of these findings. | * All patients, however, had at least one of these findings. | ||
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* [[Neck stiffness]] was present in 88%, and contrary to other reports, was not significantly lower amongst the elderly. | * [[Neck stiffness]] was present in 88%, and contrary to other reports, was not significantly lower amongst the elderly. | ||
* 11% of patients had a rash, and of these cases 73% of them were due to [[Neisseria meningitidis]] (most commonly [[petechiae]] and [[purpura]]) | * 11% of patients had a rash, and of these cases 73% of them were due to [[Neisseria meningitidis]] (most commonly [[petechiae]] and [[purpura]]) | ||
* 78% of patients had an abnormal mental status, primarily [[lethargy]] and [[confusion]] | * 78% of patients had an abnormal mental status, primarily [[lethargy]] and [[confusion]] and 23% of the patients had focal [[seizure]]s. | ||
In general | |||
* [[Headache]] is the most common symptom of meningitis (87%) | |||
* [[nuchal rigidity]] ("neck stiffness", 83%). | |||
* [[Fever]] | |||
* Altered mental status. | |||
All three features are present in only 44% of all cases of infectious meningitis.<ref>{{cite journal |author=van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M |title=Clinical features and prognostic factors in adults with bacterial meningitis |journal=N. Engl. J. Med. |volume=351 |issue=18 |pages=1849-59 |year=2004 |pmid=15509818 |doi=10.1056/NEJMoa040845}}</ref> | |||
Other symptoms commonly associated with meningitis are | |||
* [[Photophobia]] (inability to tolerate bright light) | |||
* [[Phonophobia]] (inability to tolerate loud noises) | |||
* [[Irritability]] | |||
* [[Delirium]] (in small children) | |||
* [[Seizure]]s (in 20-40% of cases) | |||
* Swelling of the [[fontanelle]] (soft spot) may be present in infants (0-6 months). | |||
* [[Vomiting]] may be present. | |||
==References== | ==References== | ||
Revision as of 17:22, 25 July 2012
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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], Kalsang Dolma, M.B.B.S.[3]
Overview
Patients with meningitis had the classic triad of fever, nuchal rigidity and change in mental status.
History and Symptoms
In the study by Durand et.al., only 2/3 of patients had the classic triad of fever, nuchal rigidity and change in mental status.
- All patients, however, had at least one of these findings.
- 95% had fever >100 degrees Fahrenheit, with a mean duration of 4 days.
- Neck stiffness was present in 88%, and contrary to other reports, was not significantly lower amongst the elderly.
- 11% of patients had a rash, and of these cases 73% of them were due to Neisseria meningitidis (most commonly petechiae and purpura)
- 78% of patients had an abnormal mental status, primarily lethargy and confusion and 23% of the patients had focal seizures.
In general
- Headache is the most common symptom of meningitis (87%)
- nuchal rigidity ("neck stiffness", 83%).
- Fever
- Altered mental status.
All three features are present in only 44% of all cases of infectious meningitis.[1] Other symptoms commonly associated with meningitis are
- Photophobia (inability to tolerate bright light)
- Phonophobia (inability to tolerate loud noises)
- Irritability
- Delirium (in small children)
- Seizures (in 20-40% of cases)
- Swelling of the fontanelle (soft spot) may be present in infants (0-6 months).
- Vomiting may be present.
References
- ↑ van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004). "Clinical features and prognostic factors in adults with bacterial meningitis". N. Engl. J. Med. 351 (18): 1849–59. doi:10.1056/NEJMoa040845. PMID 15509818.