Diagnostic Accuracy of Classic Signs of Meningitis in 297 Patients Sensitivity Specificity PPV (*) NPV (**) Kernig's sign 5% 95% 27% 72% Brudzinski's sign 5% 95% 27% 72% Nuchal rigidity
30% 68% 26% 73% (*)Positive predictive value.
Grade 0 Unruptured aneurysm Grade 1 Asymptomatic or mild headache and slight nuchal rigidity
Grade 2 Mild bleeding -- moderate to severe headache, nuchal rigidity
and cranial nerve palsy Grade 3 Moderate bleeding -- patient is lethargic with headache or nuchal rigidity
, no hemispheric neurological signs.
Physical examination showed impaired consciousness, nuchal rigidity
, and a temperature of 39.
9[degrees]C, nuchal rigidity, headache, and general malaise.
On physical examination, he was somnolent but fully oriented, with no focal findings on neurologic examination and only slight nuchal rigidity.
was present, and hyperreflexia was demonstrated in both upper limbs, although lower limb reflexes were normal.
On admission, physical examination documented fever, vomiting, encephalopathy, nuchal rigidity
, and a bilateral rash on the lower extremities.
Symptoms and signs that suggested CNS involvement were common: nuchal rigidity
was present in 28.
8%) Serology (14/26, 54%) 1950 (7) Nuchal rigidity
None Virus isolate ("a few cases") (9/50, 18%) Serology (18/24, 75%) 1950-53 (8) Meningitis None NA (1/400, 0.