Meningitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Kalsang Dolma, M.B.B.S.[3]
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.
- 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 and 23% of the patients had focal seizures.
In general
- Headache is the most common symptom of meningitis (87%)
- Nuchal rigidity ("neck stiffness", 83%).
- Fever
- 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
- Delirium (in small children)
- Seizures (in 20-40% of cases)
- Swelling of the fontanelle (soft spot) may be present in infants (0-6 months).
- 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.