Viral meningitis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Viral meningitis patients appear lethargic and may be not well oriented. They also appears feverish grading from 38-40 degrees. The signs may differ according to the patient age and the virus causing the disease as well. Different signs can be noticed like photophobia, phonophobia, nuchal rigidity,altered mental status and skin rash.<ref name="pmid10348069">{{cite journal| author=Norris CM, Danis PG, Gardner TD| title=Aseptic meningitis in the newborn and young infant. | journal=Am Fam Physician | year= 1999 | volume= 59 | issue= 10 | pages= 2761-70 | pmid=10348069 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10348069 }} </ref><ref name="pmid8337018">{{cite journal| author=Rorabaugh ML, Berlin LE, Heldrich F, Roberts K, Rosenberg LA, Doran T et al.| title=Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications. | journal=Pediatrics | year= 1993 | volume= 92 | issue= 2 | pages= 206-11 | pmid=8337018 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8337018 }} </ref> | [[Viral]] [[meningitis]] [[patients]] appear [[lethargic]] and may be not well oriented. They also appears feverish grading from 38-40 degrees. The signs may differ according to the patient age and the [[virus]] causing the [[disease]] as well. Different signs can be noticed like [[photophobia]], [[phonophobia]], [[nuchal rigidity]],[[altered mental status]], and [[skin rash]].<ref name="pmid10348069">{{cite journal| author=Norris CM, Danis PG, Gardner TD| title=Aseptic meningitis in the newborn and young infant. | journal=Am Fam Physician | year= 1999 | volume= 59 | issue= 10 | pages= 2761-70 | pmid=10348069 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10348069 }} </ref><ref name="pmid8337018">{{cite journal| author=Rorabaugh ML, Berlin LE, Heldrich F, Roberts K, Rosenberg LA, Doran T et al.| title=Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications. | journal=Pediatrics | year= 1993 | volume= 92 | issue= 2 | pages= 206-11 | pmid=8337018 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8337018 }} </ref> | ||
==Physical examination== | ==Physical examination== | ||
'''Appearance of the patient''' | '''Appearance of the patient''' | ||
*Patients usually appears lethargic and not well oriented. | *Patients usually appears [[lethargic]] and not well oriented. | ||
*Convulsions may also be noticed. | *[[Convulsions]] may also be noticed. | ||
'''Vital signs''' | '''Vital signs''' | ||
*High to low grade fever ( | *High to low grade [[fever]] (40°C/104°F) | ||
*Hypothermia | *[[Hypothermia]] | ||
*Tachypnea or apnea | *[[Tachypnea]] or [[apnea]] | ||
'''Skin''' | '''Skin''' | ||
*Vesicular or macular skin rash | *[[Vesicular]] or [[macular]] [[skin rash]] | ||
* | *[[Petechia|Petichiae]] | ||
'''HEENT''' | '''HEENT''' | ||
*Headache | *[[Headache]] | ||
*Photophobia | *[[Photophobia]] | ||
*Phonophopia | *Phonophopia | ||
*Pharyngitis in case of enterovirus infeciton | *[[Pharyngitis]] in case of [[enterovirus]] infeciton | ||
*Orchitis in case of mumps infection | *[[Orchitis]] in case of mumps infection | ||
'''Neck''' | '''Neck''' | ||
*Nuchal rigidity | *[[Nuchal rigidity]] | ||
*Signs of meningeal irritation: | *Signs of [[meningeal irritation]]: | ||
**Kernig's sign | **[[Kernig's sign]] | ||
**Brudzinski's sign | **[[Brudzinski's sign]] | ||
'''Lungs''' | '''Lungs''' | ||
*Lungs are normal in cases of the viral meningitis | *[[Lungs]] are normal in cases of the viral [[meningitis]] | ||
'''Heart''' | '''Heart''' | ||
*Normal heart sounds | *Normal heart sounds | ||
*No murmurs, gallops or rubs | *No [[murmurs]], gallops or rubs | ||
'''Abdomen''' | '''Abdomen''' | ||
*Gastroenteritis especially in cases if enteroviral meningitis | *[[Gastroenteritis]] especially in cases if enteroviral meningitis | ||
'''Neuromuscular''' | '''Neuromuscular''' | ||
*Altered mental status | *[[Altered mental status]] | ||
*Hypotonia | *[[Hypotonia]] | ||
*Normal deep tendon reflexes | *Normal deep [[tendon]] [[reflexes]] | ||
==Reference== | ==Reference== | ||
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{{WH}}{{WS}} | {{WH}}{{WS}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Neurology]] |
Latest revision as of 00:41, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Viral meningitis patients appear lethargic and may be not well oriented. They also appears feverish grading from 38-40 degrees. The signs may differ according to the patient age and the virus causing the disease as well. Different signs can be noticed like photophobia, phonophobia, nuchal rigidity,altered mental status, and skin rash.[1][2]
Physical examination
Appearance of the patient
- Patients usually appears lethargic and not well oriented.
- Convulsions may also be noticed.
Vital signs
- High to low grade fever (40°C/104°F)
- Hypothermia
- Tachypnea or apnea
Skin
HEENT
- Headache
- Photophobia
- Phonophopia
- Pharyngitis in case of enterovirus infeciton
- Orchitis in case of mumps infection
Neck
Lungs
- Lungs are normal in cases of the viral meningitis
Heart
- Normal heart sounds
- No murmurs, gallops or rubs
Abdomen
- Gastroenteritis especially in cases if enteroviral meningitis
Neuromuscular
- Altered mental status
- Hypotonia
- Normal deep tendon reflexes
Reference
- ↑ Norris CM, Danis PG, Gardner TD (1999). "Aseptic meningitis in the newborn and young infant". Am Fam Physician. 59 (10): 2761–70. PMID 10348069.
- ↑ Rorabaugh ML, Berlin LE, Heldrich F, Roberts K, Rosenberg LA, Doran T; et al. (1993). "Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications". Pediatrics. 92 (2): 206–11. PMID 8337018.