Bacterial meningitis physical examination

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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]

Overview

Physical examination

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

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

References


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