A 54-Years-Old Man Known Case of Hypertension, Diabetes Mellitus, Obesity Having Pyogenic Meningitis Due to Streptococcus Agalactiea Complicated by Multiple Small Abscesses Over Meninges, Metabolic Acidosis, Acute Kidney Injury, Transaminitis, DIC And ARD

A 54-years-old man presented with 3 days history of fever and headache followed by acute confusion. He was a known case of hypertension and diabetes mellitus for 10 years. He was obese; neck rigidity was noted; Glasgow Coma Scale was 9/15 (E3,V1, M5). Cerebrospinal fluid examination showed high protein, low normal sugar with cells predominantly neutrophils compatible with pyogenic meningitis; Streptococcus agalactiea was detected in CSF. It was complicated by metabolic acidosis, acute kidney injury, transaminitis, DIC and ARDS. He passed away 58 hours after hospitalization. Autopsy findings were discussed.