• Feeling generally unwell with fever. Most children with meningitis rapidly appear seriously ill.
• A severe headache, vomiting and photophobia (avoids bright light)
• Irritability, drowsiness, loss of consciousness and convulsions
• Young infants may present with poor feeding, lethargy and apnoea.
• Neck stiffness. It is painful if the patient tries to flex his/her neck so that the chin touches the chest. It is also painful and difficult if the examiner tries to flex the patient’s neck. Neck stiffness may be absent in young children with meningitis.
• Infants may have a full (bulging) fontanelle.

The signs of meningitis and septicaemia are very similar. Both must be suspected in any child who is seriously ill or unconscious or who has a high fever without an obvious cause.