Then the slide was examined under microscope (Olympus CH-20, Japan) using oil immersion lens for the presence of intra and extra cellular gram-negative
diplococci.
In one case of acute bacterial meningitis, Gram staining showed gram-positive
diplococci and the UF-100 bacterial count was high, whereas the culture remained negative after 7 days, probably because of antibiotic treatment before lumbar puncture.
Shape and arrangement of bacterial Isolates Single 10 Bunch of Cocci 8
Diplococci 5 Single-Red 18 Chain of Cocci 24 Bunch of Red 2 Note: Table made from pie chart.
Initial microscopic examination of cerebrospinal fluid revealed a gram-positive coccus; on review, intracellular
diplococci were identified, suggesting an undercolored specimen that likely represented Neisseria species.
The growth of one oxidase-positive colony, with the appearance of Gram-negative
diplococci was identified by a negative P-galactosidase test and the ability to oxidize glucose and maltose but not lactose and sucrose in cystine tryptic agar.
Cerebrospinal fluid cultures from 11 cases grew pneumococcus in 7 and
diplococci in 4.
Indeed, gram-negative
diplococci were found on the Gram stain.
A sputum Gram stain showed many white blood cells and gram-positive
diplococci suggestive of Streptococcus pneumoniae.
If Gram positive cocci appeared as chains or as
diplococci, Catalase tests were performed.
Probable bacterial meningitis was defined as a suspected case for which gram-stained CSF was positive (gram-negative
diplococci, gram-positive
diplococci, or gram-negative bacilli); probable meningococcal meningitis cases are limited to those with gram-negative
diplococci.
On December 4, gram-negative
diplococci were identified in the patient's CSF at 9:30 a.
Gram- negative
diplococci were identified in the material from the purpuric lesion and antibiotic therapy with ceftriaxone and vacomycin was continued.
