Diagnostic Testing for Meningitis History: • Triad: Fever, neck stiffness, and altered mental status • Sens: 44% if 2+ are present; Spec: Non-specific Kernig Sign: • Leg extension → pain in back/thighs or extension • Sens: 5% (40% if sitting up); Spec: 95% Brudzinski Sign • Passively flex neck and legs will flex • Sens: 5%; Spec: 95% Nuchal Rigidity • Neck stiffness with neck flexion • Sens: 30%; Spec: 70% Jolt Accentuation • Shake head will headache • Sens: 60-90%; Spec: 60-80% Lumbar Puncture • Glucose, WBC, protein, gram stain, culture • Sens: 60-90%; Spec: Up to 100% - VA Joint Chiefs @BostonChiefs #Meningitis #diagnosis #testing #physicalexam #Sensitivity #Specificity #diagnosis
