What physical exam finding is indicative of meningitis?

Nuchal rigidity is a critical physical exam finding indicative of meningitis. This sign refers to stiffness in the neck that makes it painful or difficult for a person to flex their neck forward. It occurs due to inflammation of the meninges, the protective membranes covering the brain and spinal cord. In meningitis, the release of inflammatory mediators and the subsequent inflammation can lead to increased tension in the neck muscles, resulting in this rigidity. When performing a physical examination on a patient suspected of having meningitis, assessing for nuchal rigidity can be pivotal, as it helps guide the clinician towards further diagnostic steps, such as lumbar puncture or imaging studies.

Other findings, such as fever, headache, and altered mental status, also support the diagnosis of meningitis but are not specifically linked to the physical rigidity observed in the neck. Other choices, while they can occur in various medical conditions, do not specifically point towards meningitis. For example, bradycardia and hypotension may be indicative of different systemic issues, and hyperreflexia could indicate neurological involvement but is not a classic sign of meningitis itself. Hence, nuchal rigidity serves as a key indicator in the clinical evaluation of suspected meningitis cases.