Meningitis history and symptoms: Difference between revisions

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{{Meningitis}}
{{Meningitis}}
 
{{CMG}}; '''Associate Editor(s)-In-Chief:'''  {{CZ}}, {{KD}}
{{CMG}}; '''Associate Editor(s)-In-Chief:'''  {{CZ}}
 
==Overview==


==History and Symptoms==
==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]].
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.
* All patients, however, had at least one of these findings.
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* [[Neck stiffness]] was present in 88%, and contrary to other reports, was not significantly lower amongst the elderly.
* [[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]])
* 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]].
* 78% of patients had an abnormal mental status, primarily [[lethargy]] and [[confusion]] and 23% of the patients had focal [[seizure]]s.
*:* 23% of the patients had focal [[seizure]]s.


In general:
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.<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>


[[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.
Other symptoms commonly associated with meningitis are  
* [[Photophobia]] (inability to tolerate bright light)
* [[Phonophobia]] (inability to tolerate loud noises)
* [[Irritability]]  
* [[Delirium]] (in small children)  
* [[Seizure]]s (in 20-40% of cases)  
* Swelling of the [[fontanelle]] (soft spot) may be present in infants (0-6 months).
* [[Vomiting]] may be present.


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
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Latest revision as of 22:42, 29 July 2020

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], 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

All three features are present in only 44% of all cases of infectious meningitis.[1]

Other symptoms commonly associated with meningitis are

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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