Fungal meningitis physical examination

Meningitis main page
Fungal meningitis Microchapters
Home
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Fungal meningitis from other Diseases
Epidemiology and Demographics
Screening
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X-ray
ECG
MRI
CT
Ultrasound
Other Imaging Findings
Other Diagnostic Findings
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Case Studies
Case #1
Fungal meningitis physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Fungal meningitis physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Fungal meningitis physical examination
CDC on Fungal meningitis physical examination
Fungal meningitis physical examination in the news
Blogs on Fungal meningitis physical examination
Directions to Hospitals Treating Fungal meningitis
Risk calculators and risk factors for Fungal meningitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby; Prince Tano Djan, BSc, MBChB [2]

Overview

As in the case of any disease, a complete physical exam must be done on the patient looking for positive and negative symptoms. The clinical presentation of fungal meningitis is usually obscure as are the findings on physical exam. The pertinent findings are low grade fever and possible neurological signs like focal weakness, loss of sensation and cranial nerves involvement.

Physical exam findings, including presence of rashes, lymphadenopathy, hepatomegaly, pulmonary disease, ocular pathology (eg, endophthalmitis, vitritis, chorioretinitis, uveitis, optic nerve involvement), and cranial nerve (CN) palsies, may narrow the differential.

Papilledema and abducens nerve palsy suggest the presence of increased intracranial pressure (ICP).

Physical Examination

Vitals

Temperature

• A low grade fever is often present

Eyes

• Nystagmus may be present.
• Extra-ocular movements may be abnormal
• Ophthalmoscopic exam may be abnormal with signs consistent with papilledema

Neurologic

• The mental status is usually intact
• Muscular strength is usually intact, but focal deficits might be present
• Sensation is usually intact, but focal deficits might be present
• Hyperactive reflexes may be present
• Deficits in cranial nerves might be present: decreased vision acuity (CN II), facial muscles weakness (CN VII), decreased hearing acuity (CNV III), diplopia (CN III, IV, V)
• Gait might be altered
• Kurnig's sign and brudzinski's sign are not typically present.