- The classic triad of fever, meningismus (stiff neck), and altered mental status only occurs in 44% of cases of acute bacterial meningitis (ABM).
- Headache is a much more common presenting complaint with ABM.
- The sensitivity and specificity of Kernig and Brudzinski signs are suboptimal, making their presence or absence of little diagnostic value.
References
- Van de Beck, D, et al. "Clinical features and prognostic factors in adults with bacterial meningitis." New England Journal of Medicine. 2004; 351 (18); 1849-59.
- Thomas KE, et al. "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis." Clinical Infectious Diseases. 2002; 35(1); 46-52.
