BACTERIAL MENINGITIS

Signs and symptoms: HEADAC

HE
Initial symptoms
High fever with
chills
 NUCCHAL RIGIDITY  “stiff neck” early sign

o Forceful flexion causes severe pain

 KERNIG’S SIGN (+) when the patient is lying with the thigh flexed on abdomen, the leg cannot be
completely extended.

 BRUDZINSKI’S SIGN (+) when the patient’s neck is flexed, flexion of the knees and hips is produced,
when passive flexion of the lower extremity of one side is made, a similar movement is seen In the opposite
extremity.

 PHOTOPHOBIA  extreme sensitivity to light

 Rapid pulse and respiratory arrhythmias

 Generalized hyperesthesia of the skin

 Soreness of the skin and muscles

 CONVULSIONS/SEIZURES-occurs in 10-80% of all patients

o Signs and symptoms of increased ICP

 Nausea

 Projectile vomiting without regards to food intake

 Sudden severe frontal headache

 Irritability

 Bulging anterior fontanel in infants

Progressive increased ICP

 Blurred vision

 Altered sensorium r/t toxic and metabolic encephalopathy

 Disturbed vision and occasional papilledema

SIGNS AND SYMPTOMS OF MENINGEAL IRRITATION

 Nucchal and spinal rigidity in prone and supine position

  Neck, shoulder and back stiffness from spasms of extensor muscles

 OPISTOTHONOS rigid spasm of the body with the back fully arched and the heels and
head bent back ue to irritation of the membranes surrounding the brain and spinal cord

MANIFESTATIONS IN INFANTS/NEWBORN

• Poor feeding • Hypothermia

• Lethargy • Seizures

• Irritability • Jaundice

• Apnea • Bulging fontanelle

• Listlessness • Pallor

• Apathy • Shock

• Fever • Hypotonia

• Shrill cry

• Hypoglycemia

• Intractable metabolic acidosis