A 43-year-old male presents to the emergency department in a stupor, accompanied by his wife. She called the ambulance because her husband was difficult to awaken this morning. She reports that for the last 3 days he has had a fever and an upper respiratory infection. Yesterday he had a headache. He has had no medical treatment. On physical examination, the patient demonstrates 103°F fever, sluggish pupil response, and nuchal rigidity. Which of the following should the clinician attempt to elicit next?

Question

Quizplus · Accepted Answer

Given the patient's symptoms of fever, upper respiratory infection, headache, stupor, and nuchal rigidity, the clinician should suspect meningitis. Kernig's sign is a clinical sign that can help support the diagnosis of meningitis. It involves resistance or pain in the lower back or hamstring when the knee is extended after flexing the hip. This sign, along with the other symptoms, suggests inflammation of the meninges, warranting further investigation and management for meningitis.

A 43-Year-Old Male Presents to the Emergency Department in a Stupor