Meningitis physical examination

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], Jesus Rosario Hernandez, M.D. [3].

## Physical Examination

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Meningitis is a medical emergency, and referral to a hospital is indicated.

### Skin

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Rapidly-spreading petechial rash is typical in "meningococcal" meningitis, 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.

### Gallery

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#### Trunk

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* Meningitis. With permission from Dermatology Atlas.[1]

* Meningititis. With permission from Dermatology Atlas.[1]>

#### Extremities

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* Meningitis. With permission from Dermatology Atlas.[1]

### Neurologic

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* Nuchal rigidity is typically assessed with the patient lying supine.
* Kernig's sign: Pain is elicited when the knees are passively extended .
* Brudzinski's sign: In infants, forward flexion of the neck may cause involuntary knee and hip flexion. Although commonly tested, the sensitivity and specificity of Kernig's and Brudzinski's tests are uncertain.[2]

## References

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1. ↑ 1.0 1.1 1.2 "Dermatology Atlas".
2. ↑ Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clin. Infect. Dis. 35 (1): 46–52. PMID 12060874.CS1 maint: Multiple names: authors list (link)

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