A nurse is caring for an adolescent in the emergency department (ED). For each assessment finding, click to specify if the finding is consistent with viral meningitis or bacterial meningitis. Each finding may support more than 1 disease process.

Rationale: Rapid deterioration today: Bacterial meningitis often progresses quickly and can become life-threatening within hours. Rapid onset of severe headache, vomiting, and altered consciousness is typical. Viral meningitis is usually more gradual and self-limited. Photophobia: Photophobia occurs in both viral and bacterial meningitis due to meningeal irritation. It is not specific to the causative agent but is a hallmark symptom of meningeal inflammation. Nuchal rigidity: Neck stiffness occurs in both types because inflammation of the meninges causes pain and restricted neck movement. It is an important clinical sign in the diagnosis of meningitis. Petechiae rash: Petechial or purpuric rash is characteristic of meningococcal bacterial meningitis, indicating vascular involvement and potential septicemia. It is rarely seen in viral meningitis.