Symptoms:

• High fever
• Severe headache
• Nausea and vomiting
• Stiff neck
• Sensitivity to light (photophobia)
• Mental status changes

Signs and tests:

Physical examination will reveal a fast heart rate, high temperature, stiff neck, and cloudy mental status.

The following tests may be performed:

• Spinal tap will show white blood cells in the spinal fluid (CSF), often with elevated protein and low glucose.
• Gram stain of CSF will show white blood cells and sometimes gram-positive bacteria (pneumococcus).
• CSF culture may grow pneumococcus.
• Blood culture may grow pneumococcus.
• A CT scan of the brain, if done, is usually normal.