Fungal meningitis physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===General appearance of patient=== | |||
===Vitals=== | ===Vitals=== | ||
====Temperature==== | ====Temperature==== | ||
*A low grade [[fever]] is often present | *A low grade [[fever]] is often present | ||
===Skin=== | |||
=== | ===HEENT=== | ||
*[[Nystagmus]] may be present. | *[[Nystagmus]] may be present. | ||
*Extra-ocular movements may be abnormal | *Extra-ocular movements may be abnormal | ||
*Ophthalmoscopic exam may be abnormal with signs consistent with papilledema | *Ophthalmoscopic exam may be abnormal with signs consistent with papilledema | ||
*Inflammed sinuses with facial tenderness in some cases. | |||
=== | ===Neck=== | ||
Neck may be stiff | |||
===Neuromuscular=== | |||
*The mental status is usually intact | *The mental status is usually intact | ||
*Muscular strength is usually intact, but focal deficits might be present | *Muscular strength is usually intact, but focal deficits might be present | ||
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*Gait might be altered | *Gait might be altered | ||
*[[Kurnig's sign]] and [[brudzinski's sign]] are not typically present. | *[[Kurnig's sign]] and [[brudzinski's sign]] are not typically present. | ||
===Lungs=== | |||
===Heart=== | |||
===Extremities=== | |||
===Abdomen, Back, Genitourinary=== | |||
==References== | ==References== | ||
Revision as of 20:29, 8 February 2017
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Fungal meningitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Fungal meningitis physical examination On the Web |
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American Roentgen Ray Society Images of Fungal meningitis physical examination |
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Risk calculators and risk factors for Fungal meningitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby; Prince Tano Djan, BSc, MBChB [2]
Overview
As in the case of any disease, a complete physical exam must be done on the patient looking for positive and negative symptoms. The clinical presentation of fungal meningitis is usually obscure as are the findings on physical exam. The pertinent findings are low grade fever and possible neurological signs like focal weakness, loss of sensation and cranial nerves involvement.
Physical exam findings, including presence of rashes, lymphadenopathy, hepatomegaly, pulmonary disease, ocular pathology (eg, endophthalmitis, vitritis, chorioretinitis, uveitis, optic nerve involvement), and cranial nerve (CN) palsies, may narrow the differential.
Papilledema and abducens nerve palsy suggest the presence of increased intracranial pressure (ICP).
Physical Examination
General appearance of patient
Vitals
Temperature
- A low grade fever is often present
Skin
HEENT
- Nystagmus may be present.
- Extra-ocular movements may be abnormal
- Ophthalmoscopic exam may be abnormal with signs consistent with papilledema
- Inflammed sinuses with facial tenderness in some cases.
Neck
Neck may be stiff
Neuromuscular
- The mental status is usually intact
- Muscular strength is usually intact, but focal deficits might be present
- Sensation is usually intact, but focal deficits might be present
- Hyperactive reflexes may be present
- Deficits in cranial nerves might be present: decreased vision acuity (CN II), facial muscles weakness (CN VII), decreased hearing acuity (CNV III), diplopia (CN III, IV, V)
- Gait might be altered
- Kurnig's sign and brudzinski's sign are not typically present.