Which signs are red flags suggesting pediatric meningitis?

• A. Nuchal rigidity (stiff neck) and altered mental status
• B. Runny nose and cough
• C. Mild fever without neurologic signs
• D. Rash on trunk

Answer: (A)

The main idea is that meningitis in a child presents with signs pointing to meningeal irritation and brain involvement. Nuchal rigidity, or a stiff neck, happens when the meninges are inflamed and the neck cannot flex easily. Altered mental status reflects central nervous system involvement, which can occur with meningitis and signals a child who may be acutely ill. Together, these signs are red flags because they indicate potential meningitis requiring urgent assessment and testing.

The other options describe symptoms that are common to illnesses that do not primarily involve the meninges. A runny nose and cough are typical of upper respiratory infections. A mild fever without neurologic signs usually isn’t specific for CNS infection. A rash on the trunk could be a benign viral eruption; it’s not by itself a clear red flag for meningitis unless there are other concerning signs like petechial or purpuric lesions that suggest meningococcemia. If red flags are present, seek prompt medical evaluation.