red flag symptoms for suspected meningitis in children

The red flag symptoms indicating suspected meningitis in children include: fever, headache, neck stiffness, and altered level of consciousness or cognition (including confusion or delirium) ¹.

In babies, a bulging fontanelle and non-blanching petechial or purpuric rash, especially if rapidly spreading or larger than 2 mm, are red flags ¹.

Other signs include ill appearance, pale, mottled skin or cyanosis, irritability, lethargy, reduced feeding, and unusual behaviour such as agitation, aggression, or subdued behaviour ¹.

Additional signs are a weak, high-pitched, or continuous cry in babies, and in older children, symptoms like vomiting, high age-specific heart rate, low blood pressure, and signs of sepsis such as cold hands and feet or capillary refill time ≥3 seconds ¹.

Any of these symptoms, especially when combined with a non-blanching petechial or purpuric rash, should prompt urgent hospital transfer ¹.