Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT which?

• A. A stiff or painful neck
• B. Sunken fontanelles
• C. Altered mental status
• D. Headache and fever

Answer: (B)

In pediatric meningitis, fever, headache, and changes in mental status are common signs, and neck stiffness can be present in older children. For infants, signs can be more subtle, but a bulging fontanelle is a key clue to increased intracranial pressure from meningitis, while a sunken fontanelle points to dehydration rather than meningitis. Because dehydration causes sunken fontanelles, this is not a typical sign of meningitis. The other signs—stiff neck, altered mental status, and the combination of headache with fever—fit meningitis presentations across different ages, making them more consistent indicators.