The Gram-positive, lancet-shaped diplococci observed in this specimen are characteristic of Streptococcus pneumoniae. A ce-rebrospinal fluid (CSF) specimen Gram stain result such as this should be promptly relayed to the clinician who is caring for the patient and can guide initial antimicrobial therapy.A pan-susceptible isolate of S. pneumoniae was recovered from CSF and blood cultures. The patient's anti-infective therapy regimen was narrowed to ceftriaxone, and her mental status markedly improved. As a result of weakness secondary to the infection, the patient was discharged to a rehabilitation facility.
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