Which physical findings suggest meningitis in patients with Haemophilus influenzae infections?

Updated: Jul 02, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Clinical manifestations of Hib meningitis are indistinguishable from other causes of bacterial meningitis.

The usual presentation consists of a few days of mild illness followed by ominous deterioration.

Altered mental status and fever are the most common findings.

Seizures and coma develop as the disease progresses.

Children may have few specific signs. Nuchal rigidity is often absent in children younger than 18 months. In infants, the disease course may be fulminant, with death occurring within a few hours.

Consider the possibility of subdural effusion, a common complication of Hib meningitis, in a patient who has been treated for 3 days with appropriate antibiotics and has experienced a tense anterior fontanelle, seizures (especially if focal), hemiparesis, or altered CNS function.


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