Severe Pneumococcal Meningitis With Intracranial Hypertension and Cerebral Venous Sinus Thrombosis in a Patient With HIV and Prior Splenectomy

We report the case of a 45-year-old man with a history of HIV infection (on antiretroviral therapy with a preserved CD4 count) and prior splenectomy, who presented with vomiting, diarrhea, confusion, and worsening headache. He was found to have Streptococcus pneumoniae meningitis complicated by intracranial hypertension requiring external ventricular drain placement and extensive cerebral venous sinus thrombosis. This case highlights the risk of severe pneumococcal infection in asplenic and immunocompromised patients and underscores the importance of prompt recognition and management.