Scrub the timeline to observe how bacterial and viral meningitis develop rapidly from non-specific malaise into critical neurological emergencies.
Acute Meningeal Inflammation Phase (12-24h)
Severe systemic invasion. Hallmark signs of meningeal irritation, intense occipital stiffness, photophobia, confusion, and petechial/purpuric skin lesions.
Interactive Tumbler Press Test
Press and hold the skin area below with a clear glass. Non-blanching purpura that stays red/purple under pressure indicates septic microvascular hemorrhage (Meningococcemia) — a 911 emergency.
Meningeal Irritation Tests
Involuntary flexion of patient's hips and knees when the neck is passively flexed forward while supine. Indicates severe meningeal tension.
Resistance or severe hamstring pain when extending the knee with the hip flexed at 90°. Common in acute bacterial meningitis.
| Parameter | Normal | Bacterial (Acute) | Viral (Aseptic) |
|---|---|---|---|
| Opening Pressure | 70–180 mm H₂O | Elevated (>200–500) | Normal to Slightly High |
| Leukocytes (WBC) | 0–5 /µL (mononuclear) | 1,000–10,000+ (Neutrophils >80%) | 50–500 (Lymphocytic) |
| Protein | 15–45 mg/dL | Markedly High (>100–500) | Normal to Mildly High |
| CSF/Serum Glucose | > 0.6 (>60%) | Markedly Low (< 0.4 / <40 mg/dL) | Normal (> 0.6) |