{
  "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.\n\nAtypical presentations of meningitis may lead to delays in diagnosis and treatment. To the best of our knowledge, reports of such cases are rare.",
  "abstract_shown": true,
  "affiliations": [
    "Emergency Medicine, Kanto Central Hospital, Tokyo, JPN",
    "Gastroenterology, National Center for Global Health and Medicine, Tokyo, JPN"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Daisuke Shiina"
    },
    {
      "affs": [
        0
      ],
      "name": "Koichi Zokumasu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0zbfxzst2krc3.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116945",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696384/",
  "id": "0zbfxzst2krc3",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://doi.org/10.7759/cureus.116945",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Emergency Medicine"
    ],
    [
      "heading",
      "Infectious Disease"
    ],
    [
      "heading",
      "Internal Medicine"
    ],
    [
      "openalex",
      "2404|Bacterial Infections and Vaccines"
    ]
  ],
  "openalex": "W7214323808",
  "pdf_url": "https://europepmc.org/articles/PMC13696384?pdf=render",
  "pmcid": "PMC13696384",
  "pmid": "42935591",
  "published": "2026-09-25",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/0zbfxzst2krc3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:45Z",
      "native_id": "PMC13696384",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.116945"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935591",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935591"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Infectious Disease",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Recurrent Pneumococcal Meningitis Without Cerebrospinal Fluid Pleocytosis and With Fulminant Septic Shock: A Case Report",
  "title_text": "Recurrent Pneumococcal Meningitis Without Cerebrospinal Fluid Pleocytosis and With Fulminant Septic Shock: A Case Report",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:44Z",
  "url": "https://research.draconitic.com/paper/0zbfxzst2krc3",
  "venue": "Cureus",
  "versions": []
}