The evaluation of viral meningitis begins with a history and physical examination.

Physical findings in someone with viral meningitis may include:

• Fever
• Stiff neck
• Brudzinski sign:
• Bending of the neck causes the hips and knees to bend
• Kernig sign:
• Extending the knees with the hips flexed causes pain and muscle spasms
• Confusion
• Lethargy:
• Excessive sleepiness

Tests are required to make the diagnosis of viral meningitis.

Tests that may be used to evaluate viral meningitis include:

• Complete blood count
• Serologic tests for viruses
• Spinal tap:
• Used to make the diagnosis of meningitis
• Encephalitis or meningitis may cause the spinal fluid to become cloudy
• The fluid can be rapidly tested for the presence of bacteria
• CT scan of the brain
• MRI scan of the brain