A nurse is assessing an 11-month-old infant. Which of the following manifestations is associated with a central nervous system infection?

Choice A reason: Oliguria, reduced urine output, is associated with renal or dehydration issues, not directly with central nervous system infections. While meningitis may cause systemic effects, oliguria is not a hallmark sign, as neurological symptoms like fontanel changes are more specific indicators. Choice B reason: A negative Brudzinski sign indicates no neck stiffness, which is inconsistent with central nervous system infections like meningitis, where meningeal irritation causes a positive sign. This finding suggests the absence of infection, making it an incorrect manifestation for this condition. Choice C reason: Jaundice, caused by liver dysfunction or hemolysis, is not typically associated with central nervous system infections. Meningitis primarily affects the meninges, causing neurological symptoms, not bilirubin elevation, making jaundice an unrelated finding in this context. Choice D reason: A bulging fontanel in an 11-month-old indicates increased intracranial pressure from a central nervous system infection like meningitis. Meningeal inflammation causes cerebrospinal fluid buildup, pressing on the open fontanel, a key diagnostic sign in infants with neurological infections.