Bacterial meningitis history and symptoms: Difference between revisions

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==Symptoms==
==Symptoms==
===Common symptoms===
===Common symptoms===
The common symptoms of acute bacterial meningitis may include fever, neck stiffness and headache. However, this classic triad may not be present in all patients with bacterial meningitis and patients may present with variable symptomatology<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><ref name="pmid8416268">{{cite journal| author=Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS et al.| title=Acute bacterial meningitis in adults. A review of 493 episodes. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 1 | pages= 21-8 | pmid=8416268 | doi=10.1056/NEJM199301073280104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8416268  }} </ref><ref name="pmid3403999">{{cite journal| author=Domingo P, Mancebo J, Blanch L, Net A, Nolla J| title=Fever in adult patients with acute bacterial meningitis. | journal=J Infect Dis | year= 1988 | volume= 158 | issue= 2 | pages= 496 | pmid=3403999 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3403999  }} </ref><ref name="pmid12060874">{{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 | year= 2002 | volume= 35 | issue= 1 | pages= 46-52 | pmid=12060874 | doi=10.1086/340979 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12060874  }} </ref>  
The common symptoms of acute bacterial meningitis may include fever, neck stiffness and headache. However, this classic triad may not be present in all patients with bacterial meningitis and patients may present with variable symptomatology<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><ref name="pmid8416268">{{cite journal| author=Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS et al.| title=Acute bacterial meningitis in adults. A review of 493 episodes. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 1 | pages= 21-8 | pmid=8416268 | doi=10.1056/NEJM199301073280104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8416268  }} </ref><ref name="pmid3403999">{{cite journal| author=Domingo P, Mancebo J, Blanch L, Net A, Nolla J| title=Fever in adult patients with acute bacterial meningitis. | journal=J Infect Dis | year= 1988 | volume= 158 | issue= 2 | pages= 496 | pmid=3403999 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3403999  }} </ref><ref name="pmid12060874">{{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 | year= 2002 | volume= 35 | issue= 1 | pages= 46-52 | pmid=12060874 | doi=10.1086/340979 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12060874 }} </ref><ref name="pmid7824999">{{cite journal| author=Chotpitayasunondh T| title=Bacterial meningitis in children: etiology and clinical features, an 11-year review of 618 cases. | journal=Southeast Asian J Trop Med Public Health | year= 1994 | volume= 25 | issue= 1 | pages= 107-15 | pmid=7824999 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7824999 }} </ref>  
*Fever
*Fever
*Headache-87%
*Headache-87%

Revision as of 16:53, 6 January 2017

Meningitis main page

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Overview

Historical Perspective

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Pathophysiology

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Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

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CT

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Other Diagnostic Studies

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Surgery

Primary Prevention

Secondary Prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

History

  • Help differentiate bactrial from other causes of meningitis
  • Acute presentation vs chronic or subacute presentation
  • Acute within 24 hours
  • Subacute or chronic-1-7 days-viral or fungal
  • Age of patient help determine the causative agent
  • Detailed history of risk factors
  • History of exposure
  • History of immunosuppression
  • History of concomittant sinusitis and otitis media- Strept pneumoniae
  • Intake of unpasterurized milk and cheese-Listria monocytogenes
  • Recent trauma or intracranial surgery

Symptoms

Common symptoms

The common symptoms of acute bacterial meningitis may include fever, neck stiffness and headache. However, this classic triad may not be present in all patients with bacterial meningitis and patients may present with variable symptomatology[1][2][3][4][5]

  • Fever
  • Headache-87%
  • Stiffness of neck-83%
  • Altered mental status

Other symptoms

Adults

Infants

  • Swelling of the fontanelle (soft spot) may be present in infants (0-6 months).
  • High pitch crying
  • Hypothermia
  • Vomiting
  • Lethargy
  • Difficulty breathing

References

  1. ↑ 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.
  2. ↑ Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS; et al. (1993). "Acute bacterial meningitis in adults. A review of 493 episodes". N Engl J Med. 328 (1): 21–8. doi:10.1056/NEJM199301073280104. PMID 8416268.
  3. ↑ Domingo P, Mancebo J, Blanch L, Net A, Nolla J (1988). "Fever in adult patients with acute bacterial meningitis". J Infect Dis. 158 (2): 496. PMID 3403999.
  4. ↑ Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clin Infect Dis. 35 (1): 46–52. doi:10.1086/340979. PMID 12060874.
  5. ↑ Chotpitayasunondh T (1994). "Bacterial meningitis in children: etiology and clinical features, an 11-year review of 618 cases". Southeast Asian J Trop Med Public Health. 25 (1): 107–15. PMID 7824999.


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