Snapshot A 56-year-old man presents to the emergency department for a severe headache, generalized malaise, and fatigue. Her symptoms are associated with neck stiffness and nausea. Physical examination is significant for nuchal rigidity 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 lancet-shaped, gram-positive cocci. Introduction Classification login to view 6 more bullets Epidemiology login to view 5 more bullets Pathogenesis login to view 3 more bullets Associated conditions login to view 4 more bullets Presentation Symptoms login to view 9 more bullets Physical exam login to view 15 more bullets Studies Gram stain and culture login to view 3 more bullets Differential Other causes of meningitis login to view 4 more bullets Other causes of otitis media login to view 2 more bullets Other causes of pneumonia login to view 1 more bullet Treatment Preventative login to view 4 more bullets Medical login to view 11 more bullets Complications Septic shock