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Clinical signs of bacterial meningitis at admission


To identify clinical signs of high sensitivity in adult community acquired bacterial meningitis on the time of admission to a hospital.


All adult cases of culture positive cerebrospinal fluids in East Denmark from 2002 to 2004 were included. Medical records were collected retrospectively with 98.4% case completeness.


132 cases were included. Only 40% had the "typical triad of symptoms" (altered consciousness, fever and nuchal rigidity). 89% had clinically altered consciousness, 77% had fever, 73% had nuchal rigidity, 70% reported headache, 16% reported convulsions prior to admission, 14% had petechiae.

75% had 3 or more of the 6 clinical signs mentioned above.

Petechiae were registered only among meningococcal (n = 11; 61% of cases) or pneumococcal (n = 6; 8% of cases) aetiology.


"3 out of 6 clinical cardinal symptoms" was more sensitive in detecting community acquired bacterial meningitis than the "typical triad of symptoms".

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Correspondence to Rasmus Køster-Rasmussen.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Køster-Rasmussen, R., Meyer, C.N. Clinical signs of bacterial meningitis at admission. Scand J Trauma Resusc Emerg Med 17 (Suppl 2), P13 (2009).

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