Meningitis history and symptoms: Difference between revisions

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==Overview==
==Overview==
==History and Symptoms==
In the study by Durand et.al., only 2/3 of patients had the classic triad of [[fever]], [[nuchal rigidity]] and [[mental status|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.
*:* [[Kernig's sign]]: inability to allow full extension of the knee when the hip is flexed 90 degrees.
*:* [[Brudzinski’s sign]]: spontaneous flexion of the hips during attempted passive neck flexion.
* 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]].
*:* 23% of the patients had focal [[seizure]]s.
In general:
[[Headache]] is the most common symptom of meningitis (87%) followed by [[nuchal rigidity]] ("neck stiffness", 83%). The classic triad of diagnostic signs consists of nuchal rigidity (being unable to flex the neck forward), [[fever]] and altered mental status. All three features are present in only 44% of all cases of infectious meningitis.<ref>{{cite journal |author=van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M |title=Clinical features and prognostic factors in adults with bacterial meningitis |journal=N. Engl. J. Med. |volume=351 |issue=18 |pages=1849-59 |year=2004 |pmid=15509818 |doi=10.1056/NEJMoa040845}}</ref> Other symptoms commonly associated with meningitis are [[photophobia]] (inability to tolerate bright light), [[phonophobia]] (inability to tolerate loud noises), [[irritability]] and [[delirium]] (in small children) and [[seizure]]s (in 20-40% of cases). In infants (0-6 months), swelling of the [[fontanelle]] (soft spot) may be present. [[Vomiting]] may be present.


==References==
==References==

Revision as of 21:03, 8 February 2012

Meningitis Main Page

Patient Information

Overview

Causes

Classification

Viral Meningitis
Bacterial Meningitis
Fungal Meningitis

Differential Diagnosis

Diagnosis

Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

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.
    • Kernig's sign: inability to allow full extension of the knee when the hip is flexed 90 degrees.
    • Brudzinski’s sign: spontaneous flexion of the hips during attempted passive neck flexion.
  • 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.

In general:

Headache is the most common symptom of meningitis (87%) followed by nuchal rigidity ("neck stiffness", 83%). The classic triad of diagnostic signs consists of nuchal rigidity (being unable to flex the neck forward), fever and 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 and delirium (in small children) and seizures (in 20-40% of cases). In infants (0-6 months), swelling of the fontanelle (soft spot) may be present. Vomiting may be present.

References

  1. 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.


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