Fast Five Quiz: Are You Familiar With Conditions Responsible for Recent Outbreaks?

Richard H. Sinert, DO

Disclosures

January 18, 2018

Meningococcal meningitis is characterized by acute onset of intense headache, fever, nausea, vomiting, photophobia, and stiff neck. Elderly patients are prone to altered mental state and a prolonged course with fever. In infants, the illness may have an insidious onset; stiff neck may be absent. In children, even when the combination of convulsive status epilepticus and fever is present, the classic signs and symptoms of acute bacterial meningitis may not be present. Seizures occur in 40% of children with meningitis, typically during the first few days. The majority of seizures have a focal onset.

A petechial or purpuric rash usually is found on the trunk, legs, mucous membranes, and conjunctivae. Occasionally, it is seen on the palms and soles. The rash may progress to purpura fulminans, when it usually is associated with multiorgan failure (ie, Waterhouse-Friderichsen syndrome). The petechial rash may be difficult to recognize in dark-skinned patients.

For more on the presentation of meningococcal meningitis, read here.

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