A 48-year-old man is admitted to hospital because of stupor. He is unkempt and homeless and lives in an encampment with other homeless people who called the authorities when he could not be easily aroused. The patient drinks a lot of fortified wine and drank excessively 2 nights previously. His temperature is 38.5 °C and his blood pressure 125/80 mm Hg. He moans when attempts are made to arouse him. He has positive Kernig and Brudzinski signs, suggesting meningeal irritation. Physical examination and chest x-ray show evidence of left lower lobe lung consolidation. Endotracheal aspirate yields rust-colored sputum. Examination of a Gram-stained sputum smear shows numerous polymorphonuclear cells and numerous grampositive lancet-shaped diplococci. On lumbar puncture, the cerebrospinal fluid is cloudy and has a white blood cell count of 570/µL with 95% polymorphonuclear cells; Gram stain shows numerous gram-positive diplococci. Based on this information, the likely diagnosis is 

(A) Pneumonia and meningitis due to Staphylococcus aureus 

(B) Pneumonia and meningitis due to Streptococcus pyogenes 

(C) Pneumonia and meningitis due to Streptococcus pneumoniae 

(D) Pneumonia and meningitis due to Enterococcus faecalis 

(E) Pneumonia and meningitis due to Neisseria meningitidis

Answer rating: 100% (QA)

Answer Option C is the answer ie Pneumonia and meningitis due to Streptococcus pne... View the full answer