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

• A. Sunken fontanelles
• B. Fever
• C. Lethargy
• D. Neck stiffness

Answer: (A)

Meningitis in infants and children typically presents with fever, lethargy (or poor responsiveness), and sometimes poor feeding or irritability. Neck stiffness is a classic sign in older children, though in infants it can be hard to assess. The fontanelle can help differentiate hydration status from raised intracranial pressure: a bulging fontanelle may indicate increased pressure from meningitis, while a sunken fontanelle points to dehydration. Therefore, a sunken fontanelle is not a sign of meningitis, making it the exception among the options. Fever, lethargy, and neck stiffness align with meningitis presentations, though exact signs can vary with age.