Snapshot An 18-year-old man presents to the emergency department for an intractable headache and generalized malaise. His symptoms began 3 days ago and have progressively worsened. Physical examination is significant for nuchal rigidity, diffuse petechia, and an inability to extend at the knee while the hips are flexed at 90°. A lumbar puncture is performed and cerebral spinal fluid studies demonstrate an elevated opening pressure, elevated protein, decreased glucose, and a leukocytosis. Gram stain of the cerebral spinal fluid demonstrates gram-negative diplococci. Introduction Classification login to view 1 more bullet Epidemiology login to view 5 more bullets Transmission login to view 1 more bullet Microbiology login to view 25 more bullets Pathogenesis login to view 5 more bullets Prevention login to view 4 more bullets Associated conditions login to view 5 more bullets Prognosis login to view 1 more bullet Presentation Symptoms login to view 5 more bullets Physical login to view 6 more bullets Studies Culture login to view 2 more bullets Differential Meningitis caused by other organisms login to view 4 more bullets Treatment Medical login to view 19 more bullets Complications Sepsis Hypovolemic shock Cerebral edema and hydrocephalus Cognitive impairment