A fatal acute bacterial meningoencephalitis with the highest cerebrospinal fluid white blood cell count ever reported in literature

We present a case of a man who had chronic otitis media caused acute bacterial meningitis due to Streptococcus pneumoniae. The neuroimaging indicated thick exudates in the CSF spaces. Our patient’s CSF consisted of frank pus. The CSF white blood cell count was highly elevated, not reported in prior literature.