PMC10436013_01
Gram stain (a) and culture plate (b) demonstrating 

Streptococcus pneumoniae

 with classical lancet shape, often in pair formation, indicating the culprit organism.
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F1
Urinary antigen and multiple peripheral blood cultures were confirmed to be positive for   S. pneumoniae   within the next 24 h.   S. pneumoniae   was identified by typical colony morphology, Gram stain and optochin susceptibility as shown in Fig. 1.
Left otomastoiditis on the patient's MRI brain scan.
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F2
Magnetic resonance imaging (MRI) of the brain and spine demonstrated left mastoiditis and bilateral maxillary sinusitis but showed no evidence of an intracranial abscess or meningeal enhancement (Fig. 2).
Facet joint septic arthritis and radiological spinal cord compression shown on the patient's MRI spine scan taken in the acute phase of the disease.
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F3
T11/12 discitis was evident with radiological evidence of spinal cord compression (Fig. 3).