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Recurrent Pneumococcal Meningitis Without Cerebrospinal Fluid Pleocytosis and With Fulminant Septic Shock: A Case Report

Year: 2026

Type: article

Abstract: Bacterial meningitis is typically diagnosed via lumbar puncture.It usually occurs with cerebrospinal fluid (CSF) abnormalities.This report describes the case of a 68-year-old man with recurrent pneumococcal meningitis and absence of significant CSF pleocytosis.Despite a thorough search, no infectious focus was identified.The patient lacked typical meningeal signs, such as neck stiffness, and did not initially present with marked alteration of consciousness.Prompt antibiotic therapy was initiated; however, the patient died on the day of admission.On the day after his death, Gram-positive diplococci were detected in blood, urine, and CSF cultures and were subsequently identified as Streptococcus pneumoniae.The CSF examination showed no findings strongly suggestive of meningitis.Atypical presentations of meningitis may lead to delays in diagnosis and treatment.To the best of our knowledge, reports of such cases are rare.

Source: Cureus

DOI: 10.7759/cureus.116945

Authors: Daisuke Shiina, Koichi Zokumasu

Institutions: National Center for Global Health and Medicine, Kanto Central Hospital

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214323808