symptoms in meningitis

 Q: The classic symptoms of acute bacterial meningitis are more common in? (select one) 

A) Youngs 

B) Adults 

Answer:  B

The objective of this question is to highlight the importance of epidemiology and history taking in clinical medicine. The three classic symptoms, known as the triad of acute bacterial meningitis are 

• fever 
• nuchal rigidity, and 
• change in mental status 

- is relatively more common in patients over the age of 60 years. 

Although nausea is not a part of the classic triad it is usually present. Also, these symptoms sudden onset in nature. 

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References:

1. van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004; 351:1849. 

2. Weisfelt M, van de Beek D, Spanjaard L, et al. Community-acquired bacterial meningitis in older people. J Am Geriatr Soc 2006; 54:1500. 

3. Attia J, Hatala R, Cook DJ, Wong JG. The rational clinical examination. Does this adult patient have acute meningitis? JAMA 1999; 282:175.