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The clinical manifestation of intracranial mycotic aneurysms (ICMAs), which are rare but carry high risks of rupture and early mortality, remains poorly understood. We present a case of an ICMA that rapidly developed and ruptured after the diagnosis of meningitis caused by (), which rarely causes bacterial meningitis. A 54-year-old man presented with a headache that worsened on coughing, without altered consciousness or vomiting.

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BACKGROUND Streptococcus pneumoniae is an uncommon but serious cause of infective endocarditis (IE), particularly in immunocompromised individuals, such as those with untreated HIV. When pneumococcal IE occurs, it is associated with high morbidity and mortality due to the high prevenance of complications such as acute valvular destruction and septic embolization. Therefore, early recognition and prompt surgical intervention are paramount to improving outcomes.

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