On admission, the pertinent findings included a temperature of 104°, a white cell count of 22,700 cells/mm³, nuchal rigidity, elevated spinal fluid pressure, and the presence of Gram-positive diplococci on a smear of spinal fluid (cultures of blood and spinal fluid were subsequently reported positive for Streptococcus pneumoniae). The patient expired 12 hours after admission in spite of intensive antibiotic therapy.

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