Meningitis history and symptoms
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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]
Overview
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.
- Kernig's sign: inability to allow full extension of the knee when the hip is flexed 90 degrees.
- Brudzinski’s sign: spontaneous flexion of the hips during attempted passive neck flexion.
- 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.
- 23% of the patients had focal seizures.
In general:
Headache is the most common symptom of meningitis (87%) followed by nuchal rigidity ("neck stiffness", 83%). The classic triad of diagnostic signs consists of nuchal rigidity (being unable to flex the neck forward), fever and 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 and delirium (in small children) and seizures (in 20-40% of cases). In infants (0-6 months), swelling of the fontanelle (soft spot) may be present. 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.