If a child is going to develop symptoms, they will appear within two weeks after exposure. All types of meningitis may appear in children either gradually or suddenly. The gradual type is harder to diagnose because the symptoms (at least at first) are vague. Much more common is the abrupt onset variety of meningitis, in which symptoms appear in less than 24 hours, with a sudden high fever (100°F to 106°F), chills, vomiting, stiff neck, intense headache in the front of the head, or a seizure. There may be muscle spasms and photophobia (eye pain when exposed to light).

Some children exhibit unusual behavior as the infection begins, including aggressiveness, irritability, agitation, delirium, or screaming, following by lethargy or coma. Some may experience a cold or ear infection before the onset of meningitis.

A baby from age three months to two years may exhibit fever, vomiting, irritability, seizures, and a high-pitched cry. The baby may suddenly become rigid, and the soft spot on the front of the head may become hard or bulging.

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