Conflict of interest: none declared. Financial support: none declared.
Diagnosing meningitis requires the information from both history-taking and physical examination in its entirety.
In adults with a history that makes meningitis a possibility, specific tests used to diagnose meningeal irritation, such as for Kernig or Brudzinski signs or nuchal rigidity, probably do not affect the reliability of the diagnosis.
In small children and the elderly, Kernig and Brudzinski signs are also probably of little or no diagnostic value.