What is a significant sign of meningitis in newborns?

A significant sign of meningitis in newborns is a bulging fontanel. The presence of a bulging fontanel often indicates increased intracranial pressure, which can occur as a result of inflammation and swelling in the brain associated with meningitis. In newborns, the fontanels are the soft spots on their heads, and they are particularly vulnerable to changes in pressure. When meningitis causes irritation and swelling of the central nervous system structures, the soft spots can become tense and protrude outward, providing a visual cue to healthcare providers that further assessment is required.

While other signs, such as a high-pitched cry and seizures, can be associated with meningitis, the bulging fontanel specifically reflects a direct physiological change that occurs in response to the infection. Additionally, fever is a common symptom of many types of infections and might not specifically indicate meningitis alone. Thus, among the options provided, bulging fontanels serve as a direct and significant indicator of possible meningitis in newborns.