Bacterial meningitis physical examination
Bacterial meningitis Microchapters |
Diagnosis |
Treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Physical examination
Physical examination of bacterial meningitis may vary in adults and in infants. Following signs may suggest bacterial meningitis:[1][2][3]
Adults
The physical examination findings in adults may include the following:
General appearance
- Patient may look distressed
- Altered mental status-not oriented in time, place and person
Vital signs
- Bradycardia may indicate increased intracranial pressure
- Increased or decreased temperature
HEENT
- Signs of infection indicating sinusitis, mastoiditis, and otitis media may help identify the source of infection and give a clue about diagnosis.
- Papilledema may indicate increased intracranial pressure.
- Neck stiffness is strongly suggestive of meningitis.
CVS
- Decreased heart rate indicates increased intracranial pressure
CNS
- Signs of neurological deficit may not be present.
Skin
- Presence of skin rash may indicate Neisseria meningitidis infection
Special tests
There are two special tests for meningitis:
- Postive kernig's sign indicate meningitis.
- Positive brudzinski's sign may suggest meningitis with a sensitivity of and specificity of
Infants
- Neck stiffenss
- Altered mental status
- Bulging fontanelle
- Convulsions
- Petechial rash
References
- ↑ Attia J, Hatala R, Cook DJ, Wong JG (1999). "The rational clinical examination. Does this adult patient have acute meningitis?". JAMA. 282 (2): 175–81. PMID 10411200.
- ↑ https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047163/ Accessed on Jan 9th, 2017
- ↑ Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.