Meningitis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
==Physical Examination== | |||
The suspicion of meningitis is generally based on the nature of the symptoms and findings on [[physical examination]]. Meningitis is a [[medical emergency]], and referral to hospital is indicated. If meningitis is suspected based on clinical examination, early administration of [[antibiotic]]s is recommended, as the condition may deteriorate rapidly. In the hospital setting, initial management consists of stabilization (e.g. securing the [[airway]] in a depressed level of consciousness, administration of [[intravenous fluid]]s in [[hypotension]] or [[Shock (medical)|shock]]), followed by antibiotics if not already administered. | |||
Nuchal rigidity is typically assessed with the patient lying [[Supine position|supine]], and both hips and knees flexed. If pain is elicited when the knees are passively extended ([[Kernig's sign]]), this indicates nuchal rigidity and meningitis. In infants, forward flexion of the neck may cause involuntary knee and hip flexion ([[Brudzinski's sign]]). Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.<ref name=Thomas_2002>{{cite journal |author=Thomas KE, Hasbun R, Jekel J, Quagliarello VJ |title=The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis |journal=Clin. Infect. Dis. |volume=35 |issue=1 |pages=46-52 |year=2002 |pmid=12060874 |doi=}}</ref> | |||
In "meningococcal" meningitis (i.e. meningitis caused by the bacteria [[Neisseria meningitidis]]), a rapidly-spreading [[petechial rash]] is typical, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet. | |||
==References== | ==References== | ||
Revision as of 21:03, 8 February 2012
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Meningitis Main Page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Physical Examination
The suspicion of meningitis is generally based on the nature of the symptoms and findings on physical examination. Meningitis is a medical emergency, and referral to hospital is indicated. If meningitis is suspected based on clinical examination, early administration of antibiotics is recommended, as the condition may deteriorate rapidly. In the hospital setting, initial management consists of stabilization (e.g. securing the airway in a depressed level of consciousness, administration of intravenous fluids in hypotension or shock), followed by antibiotics if not already administered.
Nuchal rigidity is typically assessed with the patient lying supine, and both hips and knees flexed. If pain is elicited when the knees are passively extended (Kernig's sign), this indicates nuchal rigidity and meningitis. In infants, forward flexion of the neck may cause involuntary knee and hip flexion (Brudzinski's sign). Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.[1]
In "meningococcal" meningitis (i.e. meningitis caused by the bacteria Neisseria meningitidis), a rapidly-spreading petechial rash is typical, and may precede other symptoms. The rash consists of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjunctiva, and occasionally on the palms of hands and soles of feet.