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Author Notes:

Correspondence: Evan J. Anderson, MD, Division of Pediatric Infectious Diseases, Emory Children’s Center, 2015 Uppergate Drive, Atlanta, GA, 30322 (evanderson@emory.edu).

We acknowledge the clinical microbiology laboratory technicians at Children’s Healthcare of Atlanta for their technical expertise, the Georgia Emerging Infections Program, and the US Centers for Disease Control and Prevention for serotyping the isolate.

Potential conflicts of interest: E. J. A. reports personal fees for consulting from AbbVie and clinical trial funding and editorial assistance from MedImmune, outside the submitted work.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.



  • Gram stain
  • Meningitis
  • Streptococcus pneumoniae
  • Pediatrics

Gram-positive diplococci in a cerebrospinal fluid gram stain


Journal Title:

Open Forum Infectious Diseases


Volume 3, Number 4


, Pages ofw206-ofw206

Type of Work:

Article | Final Publisher PDF


A 5-month-old girl presented with meningitis after receiving amoxicillin for bilateral otitis media. The cerebrospinal fluid (CSF) Gram stain suggested Streptococcus pneumoniae: Gram-positive diplococci with a surrounding clear area indicative of a bacterial capsule. Her CSF and blood cultures grew penicillin-resistant S pneumoniae serotype 35B. This serotype is not included in the 13-valent pneumococcal conjugate vaccine (PCV-13) and has been identified as a cause of invasive pneumococcal disease in the post-PCV-13 era.

Copyright information:

© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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