Bacterial meningitis history and symptoms
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Bacterial meningitis Microchapters |
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Diagnosis |
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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
The detailed history and symptoms of patients may help differentiate bacterial causes of meningitis from other causes of meningitis, other diseases presenting with same clinical features, age of the patient, causative organism hence appropriate treatment.[1][2][3][4]
History
- Help differentiate bacterial 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-Listeria monocytogenes
- Recent trauma or intracranial surgery
Symptoms
Common symptoms
The common symptoms of acute bacterial meningitis may include fever, neck stiffness and headache. However, this classic triad may not be present in all patients with bacterial meningitis and patients may present with variable symptomatology[5][2][3][4][6]
Other symptoms
Other symptoms besides fever, neck stiffness and headache which may present in patients suffering from meningitis may include the following symptoms in adults and infants:[6][7][8][9][10][11]
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
- ↑ 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.
- ↑ 2.0 2.1 Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS; et al. (1993). "Acute bacterial meningitis in adults. A review of 493 episodes". N Engl J Med. 328 (1): 21–8. doi:10.1056/NEJM199301073280104. PMID 8416268.
- ↑ 3.0 3.1 Domingo P, Mancebo J, Blanch L, Net A, Nolla J (1988). "Fever in adult patients with acute bacterial meningitis". J Infect Dis. 158 (2): 496. PMID 3403999.
- ↑ 4.0 4.1 Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clin Infect Dis. 35 (1): 46–52. doi:10.1086/340979. PMID 12060874.
- ↑ 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.
- ↑ 6.0 6.1 Chotpitayasunondh T (1994). "Bacterial meningitis in children: etiology and clinical features, an 11-year review of 618 cases". Southeast Asian J Trop Med Public Health. 25 (1): 107–15. PMID 7824999.
- ↑ Rothrock SG, Green SM, Wren J, Letai D, Daniel-Underwood L, Pillar E (1992). "Pediatric bacterial meningitis: is prior antibiotic therapy associated with an altered clinical presentation?". Ann Emerg Med. 21 (2): 146–52. PMID 1739200.
- ↑ Chang CJ, Chang WN, Huang LT, Huang SC, Chang YC, Hung PL; et al. (2004). "Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors". Brain Dev. 26 (3): 168–75. doi:10.1016/S0387-7604(03)00122-0. PMID 15030905.
- ↑ Oliver LG, Harwood-Nuss AL (1993). "Bacterial meningitis in infants and children: a review". J Emerg Med. 11 (5): 555–64. PMID 8308235 : 8308235 Check
|pmid=value (help). - ↑ Weisfelt M, van de Beek D, Spanjaard L, Reitsma JB, de Gans J (2006). "Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series". Lancet Neurol. 5 (2): 123–9. doi:10.1016/S1474-4422(05)70288-X. PMID 16426988.
- ↑ McGill F, Heyderman RS, Panagiotou S, Tunkel AR, Solomon T (2017). "Acute bacterial meningitis in adults". Lancet. 388 (10063): 3036–3047. doi:10.1016/S0140-6736(16)30654-7. PMID 27265346.