scholarly journals Nuchal Rigidity in Infantile Bacterial Meningitis

2019 ◽  
Vol 207 ◽  
pp. 255
Author(s):  
Kazuki Iio ◽  
Yuichi Ogawa ◽  
Takateru Ihara ◽  
Yuho Horikoshi ◽  
Hiroshi Hataya
Keyword(s):  
Bacterial Meningitis ◽  
Nuchal Rigidity

Can Seizures Be the Sole Manifestation of Meningitis in Febrile Children?

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 527-534
Author(s):  
Steven M. Green ◽  
Steven G. Rothrock ◽  
Kathleen J. Clem ◽  
Raymond F. Zurcher ◽  
Laura Mellick
Keyword(s):  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Decision Rules ◽  
Case Series ◽  
Signs And Symptoms ◽  
Viral Meningitis ◽  
Retrospective Case ◽  
Nuchal Rigidity ◽  
Referral Hospitals ◽  
Meningitis In Children

Objective. It is frequently taught that lumbar puncture is a mandatory procedure in many or all children who have fever and a seizure, because the convulsion may represent the sole manifestation of bacterial meningitis. We attempted to determine the incidence of this occult manifestation of meningitis. Design. Retrospective case series. Setting and patients. 503 consecutive cases of meningitis in children aged 2 months to 15 years seen at two referral hospitals during a 20-year period. Main outcome measures. Signs and symptoms of meningitis in patients having associated seizures. Results. Meningitis was associated with seizures in 115 cases (23%), and 105 of these children were either obtunded or comatose at their first visit with a physician after the seizure. The remaining 10 had relatively normal levels of consciousness and either were believed to have viral meningitis (2) or possessed straightforward indications for lumbar puncture: nuchal rigidity (6), prolonged focal seizure (1), or multiple seizures and a petechial rash (1). No cases of occult bacterial meningitis were found. Conclusion. In our review of 503 consecutive children with meningitis, none were noted to have bacterial meningitis manifesting solely as a simple seizure. We suspect that this previously described entity is either extremely rare or nonexistent. Commonly taught decision rules requiring lumbar puncture in children with fever and a seizure appear to be unnecessarily restrictive.

scholarly journals Isolated Torticollis May Present as an Atypical Presentation of Meningitis

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Roger Chirurgi ◽  
Samrina Kahlon
Keyword(s):  
Case Report ◽  
Bacterial Meningitis ◽  
Adult Patient ◽  
Lumbar Puncture ◽  
Immunocompromised Patient ◽  
Medical Emergency ◽  
Atypical Presentation ◽  
Immunocompromised Patients ◽  
Nuchal Rigidity ◽  
Life Threatening

Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare.Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient.Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis.Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

scholarly journals Outbreak of bacterial meningitis after spinal anaesthesia in Bangladesh

2014 ◽  
Vol 22 (1) ◽  
pp. 5-11 ◽  
Author(s):  
AKM Akhtaruzzaman ◽  
Begum Maksuda Farida Akhtar ◽  
Joysree Roy ◽  
Manzoorul Hoque Laskar ◽  
Satyajit Dhar ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Spinal Anaesthesia ◽  
Anaesthetic Agent ◽  
Altered Level ◽  
Nuchal Rigidity ◽  
Elevated Protein ◽  
Level Of Consciousness ◽  
Normal Glucose ◽  
Elevated Protein Level ◽  
Iatrogenic Meningitis

Iatrogenic meningitis following spinal anaesthesia is very rare. Recently we have experienced severe headache, vomiting, fever, restlessness, nuchal rigidity and altered level of consciousness 5-6 hours after spinal anaesthesia in one hundred and nineteen patients diagnosed as iatrogenic bacterial meningitis during the period of September 2008 to March 2009. Patients were successfully treated with Inj. Ceftriaxone 2gm BID for 14 days, Inj. Dexamethasone 20mg daily in four divided dose for five days. Purulent CSF, high cell count (1570mm-3), elevated protein level (269mg/dl) and normal glucose (57mg/dl) levels in CSF were noted. There were 5 (4.2%) cases of mortality. No causative organisms were isolated from CSF, blood of the affected patients and anaesthetic agent used for the block. In conclusion, the cause of meningitis was diagnosed as bacterial in origin though no organism was isolated. DOI: http://dx.doi.org/10.3329/jbsa.v22i1.18084 Journal of BSA, 2009; 22(1): 5-11

Glycerol Aids Outcomes in Bacterial Meningitis

2005 ◽  
Vol 39 (2) ◽  
pp. 11
Author(s):  
MITCHEL L. ZOLER
Keyword(s):  
Bacterial Meningitis

Multiple Cerebral Aneurysm - Case Report

2014 ◽  
Vol 21 (3) ◽  
pp. 279-282 ◽  
Author(s):  
C. Kakucs ◽  
I. St. Florian
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Scan ◽  
Cerebral Aneurysm ◽  
Internal Carotid ◽  
Neurological Status ◽  
Posterior Communicating Artery ◽  
Nuchal Rigidity ◽  
Angio Ct

Abstract This 41-years-old female presented with somnolence, confusion and nuchal rigidity. Preoperative angio-CT scan showed two aneurysm located on both internal carotid artery (ICA) at the site of posterior communicating artery (PComA). During surgery we discovered another dilatation on the origin of left ophtalmic artery that proves to be an infundibullum. We clipped the two communicating posterior aneurysm from the left side and the ophtalmic infundibullum was wrapped. Seven days after surgery the neurological status was improved and she was transferred to the Neurological department.

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