Molly's Meningitis
Three-year-old Molly was brought to the emergency department crying. She had a stiff neck and high fever (40°C, or 104°F). Gram stain of her
cerebrospinal fluid revealed Gram-positive cocci, generally in pairs. The attending physician diagnosed Molly with meningitis and immediately
prescribed intravenous ampicillin. Unfortunately, the child's condition worsened, so antibiotic treatment was changed to a third-generation
cephalosporin (ceftriaxone). Molly began to improve within hours and was released after 2 days. A report from the clinical microbiology laboratory 2
days later identified the organism as Streptococcus pneumoniae. The report also included antibiotic susceptibility results, which revealed that this
strain of S. pneumoniae was resistant to ampicillin but remained susceptible to cephalosporin.