{"id":"https://openalex.org/W7214323808","doi":"https://doi.org/10.7759/cureus.116945","title":"Recurrent Pneumococcal Meningitis Without Cerebrospinal Fluid Pleocytosis and With Fulminant Septic Shock: A Case Report","display_name":"Recurrent Pneumococcal Meningitis Without Cerebrospinal Fluid Pleocytosis and With Fulminant Septic Shock: A Case Report","publication_year":2026,"publication_date":"2026-09-25","ids":{"openalex":"https://openalex.org/W7214323808","doi":"https://doi.org/10.7759/cureus.116945","pmid":"https://pubmed.ncbi.nlm.nih.gov/42935591","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13696384"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.116945","doi":"https://doi.org/10.7759/cureus.116945","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116945","pdf_url":"https://www.cureus.com/articles/511041-recurrent-pneumococcal-meningitis-without-cerebrospinal-fluid-pleocytosis-and-with-fulminant-septic-shock-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/511041-recurrent-pneumococcal-meningitis-without-cerebrospinal-fluid-pleocytosis-and-with-fulminant-septic-shock-a-case-report.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5152842920","display_name":"Daisuke Shiina","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210094012","display_name":"National Center for Global Health and Medicine","ror":"https://ror.org/00r9w3j27","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210094012"]},{"id":"https://openalex.org/I4210124220","display_name":"Kanto Central Hospital","ror":"https://ror.org/02tt4fr50","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210124220"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Daisuke Shiina","raw_affiliation_strings":["Emergency Medicine, Kanto Central Hospital, Tokyo, JPN","Gastroenterology, National Center for Global Health and Medicine, Tokyo, JPN"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emergency Medicine, Kanto Central Hospital, Tokyo, JPN","institution_ids":["https://openalex.org/I4210124220"]},{"raw_affiliation_string":"Gastroenterology, National Center for Global Health and Medicine, Tokyo, JPN","institution_ids":["https://openalex.org/I4210094012"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5004676245","display_name":"Koichi Zokumasu","orcid":"https://orcid.org/0000-0002-3810-189X","observed_orcids":["https://orcid.org/0000-0002-3810-189X"]},"institutions":[{"id":"https://openalex.org/I4210124220","display_name":"Kanto Central Hospital","ror":"https://ror.org/02tt4fr50","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210124220"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Koichi Zokumasu","raw_affiliation_strings":["Emergency Medicine, Kanto Central Hospital, Tokyo, JPN"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emergency Medicine, Kanto Central Hospital, Tokyo, JPN","institution_ids":["https://openalex.org/I4210124220"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5152842920"],"corresponding_institution_ids":["https://openalex.org/I4210094012","https://openalex.org/I4210124220"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.66217884,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"9","first_page":"e116945","last_page":"e116945"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10873","display_name":"Bacterial Infections and Vaccines","score":0.9775000214576721,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10873","display_name":"Bacterial Infections and Vaccines","score":0.9775000214576721,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10654","display_name":"Pneumonia and Respiratory Infections","score":0.012500000186264515,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12167","display_name":"Bacterial Identification and Susceptibility Testing","score":0.003000000026077032,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/streptococcus-pneumoniae","display_name":"Streptococcus pneumoniae","score":0.9990000128746033},{"id":"https://openalex.org/keywords/csf-pleocytosis","display_name":"cerebrospinal fluid pleocytosis","score":0.8579999804496765},{"id":"https://openalex.org/keywords/septic-shock","display_name":"septic shock","score":0.8450000286102295},{"id":"https://openalex.org/keywords/cerebrospinal-fluid-culture","display_name":"cerebrospinal fluid culture","score":0.5740000009536743},{"id":"https://openalex.org/keywords/delayed-diagnosis","display_name":"delayed diagnosis","score":0.5249999761581421},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.5180000066757202}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9904999732971191},{"id":"https://openalex.org/C2781107259","wikidata":"https://www.wikidata.org/wiki/Q5508364","display_name":"Fulminant","level":2,"score":0.7652000188827515},{"id":"https://openalex.org/C2781026528","wikidata":"https://www.wikidata.org/wiki/Q48143","display_name":"Meningitis","level":2,"score":0.5482000112533569},{"id":"https://openalex.org/C2777483564","wikidata":"https://www.wikidata.org/wiki/Q749881","display_name":"Pleocytosis","level":3,"score":0.5001999735832214},{"id":"https://openalex.org/C2779651940","wikidata":"https://www.wikidata.org/wiki/Q54196","display_name":"Cerebrospinal fluid","level":2,"score":0.4982999861240387},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.45100000500679016},{"id":"https://openalex.org/C2777628635","wikidata":"https://www.wikidata.org/wiki/Q1765564","display_name":"Septic shock","level":3,"score":0.4250999987125397},{"id":"https://openalex.org/C2778866548","wikidata":"https://www.wikidata.org/wiki/Q7205991","display_name":"Pneumococcal conjugate vaccine","level":4,"score":0.4169999957084656},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.33379998803138733},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3192000091075897},{"id":"https://openalex.org/C3018430615","wikidata":"https://www.wikidata.org/wiki/Q48143","display_name":"Bacterial meningitis","level":3,"score":0.31360000371932983},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.30880001187324524},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.30320000648498535},{"id":"https://openalex.org/C2776152631","wikidata":"https://www.wikidata.org/wiki/Q4366062","display_name":"Pneumococcal infections","level":4,"score":0.2919999957084656},{"id":"https://openalex.org/C2775956843","wikidata":"https://www.wikidata.org/wiki/Q924421","display_name":"Septic arthritis","level":3,"score":0.26579999923706055},{"id":"https://openalex.org/C2781253189","wikidata":"https://www.wikidata.org/wiki/Q221179","display_name":"Streptococcus pneumoniae","level":3,"score":0.2587999999523163},{"id":"https://openalex.org/C2910667942","wikidata":"https://www.wikidata.org/wiki/Q48143","display_name":"Cerebrospinal meningitis","level":3,"score":0.25369998812675476}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.116945","doi":"https://doi.org/10.7759/cureus.116945","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116945","pdf_url":"https://www.cureus.com/articles/511041-recurrent-pneumococcal-meningitis-without-cerebrospinal-fluid-pleocytosis-and-with-fulminant-septic-shock-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13696384","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13696384/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13696384/pdf/cureus-0018-00000116945.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"},{"id":"pmid:42935591","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42935591","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Case Reports"}],"best_oa_location":{"id":"doi:10.7759/cureus.116945","doi":"https://doi.org/10.7759/cureus.116945","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116945","pdf_url":"https://www.cureus.com/articles/511041-recurrent-pneumococcal-meningitis-without-cerebrospinal-fluid-pleocytosis-and-with-fulminant-septic-shock-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7214323808.pdf","grobid_xml":"https://content.openalex.org/works/W7214323808.grobid-xml"},"referenced_works_count":14,"referenced_works":["https://openalex.org/W26296865","https://openalex.org/W2077137971","https://openalex.org/W2096532993","https://openalex.org/W2108054631","https://openalex.org/W2143206150","https://openalex.org/W2253779069","https://openalex.org/W2942386417","https://openalex.org/W2965146627","https://openalex.org/W2965706892","https://openalex.org/W3135054338","https://openalex.org/W4211084498","https://openalex.org/W4214915479","https://openalex.org/W4390449070","https://openalex.org/W4392626888"],"related_works":["https://openalex.org/W1842144925","https://openalex.org/W26296865","https://openalex.org/W2415924961","https://openalex.org/W1971140068","https://openalex.org/W2965706892","https://openalex.org/W1005787089","https://openalex.org/W2118842786","https://openalex.org/W2111006662","https://openalex.org/W2624547508","https://openalex.org/W3129944200"],"abstract_inverted_index":{"Bacterial":[0],"meningitis":[1,26,106],"is":[2],"typically":[3],"diagnosed":[4],"via":[5],"lumbar":[6],"puncture.It":[7],"usually":[8],"occurs":[9],"with":[10,23,55],"cerebrospinal":[11],"fluid":[12],"(CSF)":[13],"abnormalities.This":[14],"report":[15],"describes":[16],"the":[17,65,69,73,115],"case":[18],"of":[19,29,58,71,102,105,117,121],"a":[20,33],"68-year-old":[21],"man":[22],"recurrent":[24],"pneumococcal":[25],"and":[27,50,85,88,113],"absence":[28],"significant":[30],"CSF":[31,86,95],"pleocytosis.Despite":[32],"thorough":[34],"search,":[35],"no":[36,98],"infectious":[37],"focus":[38],"was":[39,62],"identified.The":[40],"patient":[41,66],"lacked":[42],"typical":[43],"meningeal":[44],"signs,":[45],"such":[46,122],"as":[47,92],"neck":[48],"stiffness,":[49],"did":[51],"not":[52],"initially":[53],"present":[54],"marked":[56],"alteration":[57],"consciousness.Prompt":[59],"antibiotic":[60],"therapy":[61],"initiated;":[63],"however,":[64],"died":[67],"on":[68],"day":[70,74],"admission.On":[72],"after":[75],"his":[76],"death,":[77],"Gram-positive":[78],"diplococci":[79],"were":[80,89],"detected":[81],"in":[82,111],"blood,":[83],"urine,":[84],"cultures":[87],"subsequently":[90],"identified":[91],"Streptococcus":[93],"pneumoniae.The":[94],"examination":[96],"showed":[97],"findings":[99],"strongly":[100],"suggestive":[101],"meningitis.Atypical":[103],"presentations":[104],"may":[107],"lead":[108],"to":[109],"delays":[110],"diagnosis":[112],"treatment.To":[114],"best":[116],"our":[118],"knowledge,":[119],"reports":[120],"cases":[123],"are":[124],"rare.":[125]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-09-26T00:00:00"}