case_images: PMC10436013_01
case_images: Gram stain (a) and culture plate (b) demonstrating 
  
  Streptococcus pneumoniae
  
   with classical lancet shape, often in pair formation, indicating the culprit organism.
case_images: acmi-5-611.v3-g001.jpg
case_images: PMC10436013_01_acmi-5-611.v3-g001.jpg
case_images: F1
case_images: Urinary antigen and multiple peripheral blood cultures were confirmed to be positive for   S. pneumoniae   within the next 24 h.   S. pneumoniae   was identified by typical colony morphology, Gram stain and optochin susceptibility as shown in Fig. 1.
case_images: Left otomastoiditis on the patient's MRI brain scan.
case_images: acmi-5-611.v3-g002.jpg
case_images: PMC10436013_01_acmi-5-611.v3-g002.jpg
case_images: F2
case_images: Magnetic resonance imaging (MRI) of the brain and spine demonstrated left mastoiditis and bilateral maxillary sinusitis but showed no evidence of an intracranial abscess or meningeal enhancement (Fig. 2).
case_images: Facet joint septic arthritis and radiological spinal cord compression shown on the patient's MRI spine scan taken in the acute phase of the disease.
case_images: acmi-5-611.v3-g003.jpg
case_images: PMC10436013_01_acmi-5-611.v3-g003.jpg
case_images: F3
case_images: T11/12 discitis was evident with radiological evidence of spinal cord compression (Fig. 3).