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(a) Acute purulent meningitis caused by the Streptococcus pneumoniae. Leptomeninges expanded by a dense necroinflammatory infiltrate with neutrophils, lymphocytes, and macrophages (H&E 40×). (b) Gram stain of exudate specimens showing gram-positive diplococci (Both courtesy of Anthony Yachnis, MD, and Kelly Devers, MD, University of Florida College of Medicine)
