Gorbach SL, Bartlett JG, Blacklow NR, eds. Near the end of the first paragraph of the right-hand column on page 493, the text mentions that the Brudzinski sign has a 97 percent sensitivity in the diagnosis of acute meningitis in adults. Neck stiffness has a pooled sensitivity of 70 percent. The Kernig sign was found to have a sensitivity of 57 percent in the original study, but a later study reported a sensitivity of only 9 percent. The authors of the study reviewed in this Tip concluded that meningitis can be ruled out if a patient does not have fever, stiff neck or mental status changes.
Fever is the most sensitive of the three signs, and neck stiffness is the next most sensitive.
Kernig and Brudzinski signs, although poorly tested, seem to be specific for the diagnosis of meningitis. The authors do not believe that either sign is sensitive enough to be used for making the diagnosis of meningitis. The links above will take you to the corrected items, which remain part of the online issues in which they were originally published. Please include your complete address, telephone number and fax number. Letters should be double-spaced, fewer than 500 words and limited to one table or figure and six references.