M Tuberculoma, presenting with features of meningism
like neck rigidity, positive Kernig's sign and Brudzinski's sign is not very common, but it was the presenting feature in our patient.
Patients with fever, meningism
, confusion, focal signs and a history suggestive of vascular lesions or risk factors for dural venous sinus thrombosis should have a CECT only.
Neck stiffness as cerebellar tonsils compress against the foramen magnum (as opposed to meningism
from meningitis beware of performing a lumbar puncture in the patient with tonsillar herniation)
On neurological examination, signs of meningism
are uncommon but neck stiffness can be seen occasionally.
Headache with fever can indicate meningism
, a condition in which the person is unable to move the neck forward.
After cessation of the convulsion, we re-examined the child and did not find any signs of meningism
except extreme lethargy.
There was no meningism
or clear focal neurological deficit, so lumbar puncture was not performed.
Dutta et al mentioned in their report that triad of fever, meningism
and leukocytosis, as seen in our patient, may be suggestive for PA.
A minority of victims go on to meningism
, headache and fever then weakness in one or more muscle groups, which may progress to widespread paresis, respiratory failure and death.
Systemic Family history features Fever/night sweats, weight loss, arthropathy, rash, ulcers, dry mouth and eyes, ocular disease Neurological Persistent headache, fits, features encephalopathy, meningism
, movement disorders, stroke-like events, peripheral neuropathy Investigations Raised ESR and/or CRP, serology; abnormal CXR Absent oligoclonal bands or persistent CSF pleocytosis Normal MRI or pronounced meningeal enhancement Table 2.
The examination at the time of admission showed a drowsy patient, no meningism
, pupils equal and reactive to light and accommodation, intact corneal and gag reflexes and no dysphagia present.
There were no signs of meningism
and the cranial nerves were all functional.
But the sheriff said Gray had effectively sought to exclude meningism
when that could only have been done by a hospital.
They describe topics of common concern, such as meningitis and meningism
, gastrointestinal infection, community-acquired pneumonia, rash in pregnancy and in children, illness in returning travelers, sexually-transmitted infections, jaundice, infection in those whose immune systems are compromised, and queries about vaccines.
Meningococcal disease is typically diagnosed in children at presentation to a hospital after the onset of late-occurring classic symptoms, which include hemorrhagic rash, meningism
, and impaired consciousness.