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Meningitis Assessment

Men-in-tights with Assess-man
Picmonic
Meningitis is an inflammation of the meningeal membrane that surrounds the brain and spinal cord. Most cases are viral; however, bacterial and fungal infections occur and can be life-threatening. Bacterial meningitis is contagious and spread via respiratory droplet.
10 KEY FACTS
ASSESSMENT
Nausea and Vomiting
Vomiting

Nausea and vomiting is often seen in meningitis as the rising intracranial pressure exerts pressure on the control centers of the brain that stimulate vomiting. In scenarios where intracranial pressure is extremely high (like hemorrhage) we often see a classic projectile vomiting.

Fever
Fever-beaver

A sudden high fever is one of the key signs of meningitis and may be accompanied by chills. A high fever increases the metabolic rate and can lead to insensible fluid loss, so be sure to assess for dehydration and encourage adequate fluid intake.

Nuchal Rigidity
Brass-knuckles punching Stone-neck

Nuchal rigidity, otherwise known as a stiff neck, is another key sign of meningitis. In conjunction with this, a positive Kernig’s sign or Brudzinski’s sign may be present. A positive Kernig’s sign is assessed when pain limits passive extension of the knee when lying supine with the hip and knee flexed at 90 degrees. A positive Brudzinski’s sign is when flexion of the neck causes involuntary flexion of the knee and hip.

Severe Headache
Head-egg-lump

A severe headache that isn’t like any other type of headache is often present. Headaches may continue for several months until inflammation and irritation are resolved. It is important to implement pain management.

Purpura
Purple-cat

Purpura is a dark purple rash that occurs on the skin. This symptom is characteristic of meningococcemia, or meningococcal infection in the bloodstream. This condition is associated with septic shock-like symptoms and will have a rapid onset. Treat immediately as death can occur in as little as a few hours.

Seizures
Caesar

Seizures often occur due to irritation of the cerebral cortex and high fever that is unresponsive to antipyretics or cooling blankets. Bacterial infections have a higher incidence of seizure activity.

Photophobia
Afraid-of-light

Photophobia, known as increased sensitivity to light, is another possible symptom of meningitis.

INFANTS AND YOUNG CHILDREN
Opisthotonus Position
Severe hyperextension of Pistol-body

Opisthotonus is a position of severe hyperextension of the head, neck, and spinal column resembling a bridging or arching position. It is often pronounced in infants with meningitis.

High Pitched Cry
Crying baby

A high pitched cry, or constant crying, may be a sign of meningitis.

Bulging Fontanel
Bulging Fountain

Infants with meningitis may have a bulging fontanel (soft spot on head).

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