The correct answers are A. Fever, D. Lethargy, and E. Bulging fontanelles.

Meningitis is an infection of the meninges (coverings of the brain and spinal cord) and presents differently in infants compared to adults.

Common signs of meningitis in infants include:

Fever (A)

Lethargy or decreased level of consciousness (D)

Bulging fontanelles (E) → due to increased intracranial pressure

Irritability

Poor feeding

Seizures

NREMT-aligned references state:

“Infants with meningitis may present with fever and lethargy.”

“A bulging fontanelle is a key sign of increased intracranial pressure in infants.”

Why the other options are incorrect:

B. Drooling → More associated with epiglottitis or airway obstruction, not meningitis

C. Pale skin → Nonspecific finding, not characteristic of meningitis

F. Inability to stay still → More commonly associated with pain, anxiety, or stimulant conditions, not a classic meningitis sign

Exact Extracts (NREMT-aligned EMT educational references):

“Signs of meningitis in infants include fever, lethargy, and bulging fontanelles.”

“Increased intracranial pressure may cause bulging of the fontanelle.”

“Altered mental status is common in CNS infections.”

Clinical Priority Summary:

In infants, meningitis typically presents with fever, decreased responsiveness, and bulging fontanelles, making A, D, and E the correct answers.