Most of the symptoms and signs are similar for both the bacterial and the viral meningitis, and there is no one symptom or sign that is specifically indicate one or the other. The common clinical symptoms that may indicate meningitis are fever associated with seizures, impairment of consciousness, irritability, lethargy, nausea and/or vomiting.
The important signs indicating meningitis includes neck stiffness (pain or resistance to someone flexing the child's neck) and increased sensitivity to light (photophobia), usually in the presence of drowsiness or irritability.
For young infants where the anterior fontanel (soft spot on the top of the head) have not closed, this could be under increased pressure and bulging out of the scalp (bulging fontanel). Signs of bleeding under the skin (purpuric rash) together with other symptoms or signs indicating involvement of the brain may also suggest bacterial meningitis.
In infant and young child with no clear source of infection for the fever present, a high index of suspicion need to maintained for the diagnosis of meningitis. To confirm or exclude the diagnosis of meningitis, doctors often have to perform a procedure called a lumbar puncture, to obtain cerebrospinal fluid for testing and culture for the micro-organisms.