Acute Bacterial Meningitis - Clinical

Classic clinical picture of meningitis, irrespective of etiology, bacterial or viral infection, include the following: fever, severe headache and persistent vomiting jet (central type vomiting), neck stiffness (stiff and painful neck movement), seizure disorders andof consciousness. These clinical manifestations are found in most patients. Symptoms of bacterial meningitis starts suddenly from meningitis of viral etiology in which symptoms are installed within a few days. Other elements that complement the clinical picture are: photophobia (increased sensitivity of eyes to light), muscle fatigue and muscle pain, muscle stiffness, fatigue and profuse sweating. Signs of irritation is objectifies meningiana by three elements: neck stiffness, Kernig sign and Brudzinski sign. Brudzinski sign is obtained as follows: Place patient in supine position (lying down) with legs stretched, bent one of the legs on the abdomen. In case of irritation meningiana limb will not keep lying, but will partially flexed. For patient positioning throughout Kernig sign in supine and legs outstretched, enter the patient's head and right arm as he sat suddenly rise, while the left hand keep the knees slightly pressed patient. In case of irritation meningiana patient involuntarily flexed legs and thighs and upper limbs easily lead back.
Consciousness as quickly alter the clinical picture worsens in the absence of proper treatment, the patient delirand or not recognize family and friends. Consciousness is often going to seriously alter the state of coma.
Seizures occur in half of patients. In the case of meningitis caused by Neisseria meningitidis in the early stages of the disease recurring seizures and focal neurological deficits are more common. One quarter of all cases of bacterial meningitis meet cranial nerve palsy, the most affected are the cranial nerves IV, VI and VII, the paralysis can be co gender focal neurological deficits of visual field defects, hemiparesis and disfazia.
Increased intracranial pressure is suggested by a bilateral VI nerve palsy that manifests itself through an external straight muscle paresis. If meningitis is not treated the clinical picture will be complicated by hypertension, bradycardia and III palsy in these cases the prognosis is greatly worsened. Seizures, focal neurological deficits and encephalopathy may occur because of ischemia, cortical infarction, increased intracranial pressure due to the occurrence or subdural effusion.
Approximately half of patients develop a skin rash, poignant, erythematosus, especially in the extremities. The skin rash is a rapid evolution to a phase petechiae and purpuric merge into one form. Sometimes areas of necrosis are found in the center of purple. Skin rash is seen more common in meningitis caused by Staphylococcus aureus, strains of Acinetobacter in the case of viral meningitis etiology. Rashes occur rarely in the clinical picture of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae. Nearly a quarter of patients bacterial meningitis caused by Neisseria meningitidis and Haemophilus influenzae is complicated by pneumonia, otitis media and sinusitis.
In some situations perzinta Bacterial meningitis with atypical clinical picture. In infants and young children the clinical picture evolves differently than adults, they just presenting fever, loss of appetite, restlessness, vomiting, diarrhea and rash. Bacterial meningitis in the elderly may manifest as dizziness and lethargy, with profound alteration of consciousness, fever can be absent.