Pneumococcal meningitis is caused by Streptococcus pneumoniae and is characterized by fever, neck stiffness, bulging fontanelle, irritability, and lethargy. 

-S pneumoniae is the most common cause of meningitis in adults and children 

-Individuals with splenectomy, sickle cell disease, cochlear implants are at higher risk for pneumococcal meningitis 

Symptoms & Signs: nuchal rigidity, irritability, confusion or altered mental status, headache, photophobia, nausea, vomiting, Brudzinski (neck flexion) and Kernig (straight leg raise) signs

Diagnosis: CSF culture 

Treatment: Start antibiotics within 60 minutes if bacterial meningitis is suspected; A 2-week course of intravenous antimicrobial therapy with vancomycin, ceftriaxone, cefotaxime, Penicillin G, Ampicillin 

-Survivors should be followed for neurologic sequelae like hearing loss, motor and cognitive impairment