Clinical presentation

A. Eighty-five percent of patients with bacterial meningitis present with fever, headache, meningismus or nuchal rigidity, and altered mental status. Other common signs and symptoms include photophobia, vomiting, back pain, myalgias, diaphoresis, and malaise. Generalized seizures can occur in up to 40% of patients with ABM.

B. Kernig's sign (resistance to extension of the leg while the hip is flexed) and Brudzinski's sign (involuntary flexion of the hip and knee when the patient's neck is abruptly flexed while laying supine) are observed in up to 50% of patients.

C. About 50% of patients with N. meningitidis may present with an erythematous macular rash, which progresses to petechiae and purpura.

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