Bacterial Meningitis: Signs/Symptoms in Newborns & Younger Children von John Fisher, MD

A 61-year-old woman is brought to the emergency department for altered mental status which developed this morning. On exam, she is febrile (102°F) and confused. Her pupils are equal, round, regular, and reactive, but she exhibits a left VI nerve palsy. Her lungs reveal dullness to percussion and bronchial breath sounds in the right lower lung field. The heart and abdominal exam is unremarkable, but her neck is stiff and, when flexed, results in bilateral hip flexion. In addition to nuchal rigidity, what is the name of the physical finding that suggests meningeal irritation?

Of the following signs of meningitis in adults, which one is most indicative of a bacterial infection over a viral infection?

Which of the following clinical manifestations is less commonly seen in a newborn bacterial meningitis than in an adult bacterial meningitis?