meningitis
Online learning module on bacterial meningitis and septicaemia
Meningeal Irritation
Signs of meningeal irritation
Bacterial meningitis is present in approximately 30% of children with signs of meningeal irritation. (Oostenbrink et al, 2001)
Brudzinski's Sign
Technique
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Patient supine
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Immobilize trunk against bed
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Flex neck, chin to chest
Positive Test suggesting Meningeal Irritation
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Involuntary hip flexion
Sensitivity: 9-14%
Specificity: 94-96%
(McGee, 2013)
Video courtesy MDforAll channel, YouTube
Kernig's Sign
Technique
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Patient supine
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Flex both hip and knee to 90 degrees
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Hold hip immobile and extend knee
Positive Test suggesting Meningeal Irritation
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Resistance to knee extension
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Pain in hamstrings
Sensitivity: 9-18%
Specificity: 93-96%
(McGee, 2013)
Video courtesy MDforAll channel, YouTube
Nuchal Rigidity
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Involuntary muscle spasm limits passive neck flexion
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Patient cannot flex neck to place chin on chest
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Unreliable in age under 18 months due to underdeveloped neck musculature
Sensitivity: 41-52%
Specificity: 69-71%
(McGee, 2013)