Bacterial meningitis history and symptoms

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

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

• Fever
• Headache
• Stiffness of neck
• Altered mental status

Other symptoms

Adults

• Photophobia (inability to tolerate bright light)
• Phonophobia (inability to tolerate loud noises)
• Irritability
• Altered mental status (in small children)
• Seizures (in 20-40% of cases)
• Vomiting may be present.
• Nausea
• Increased sleepiness
• Anorexia

Infants

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

References

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