This case illustrates layering material within the lateral ventricles that almost certainly represents pus, even though there is no appreciable leptomeningeal or ependymal enhancement, which would be expected with this amount of pus.

Dilatation of the optic nerve sheaths bilaterally which can be seen in a setting of increased intracranial pressures, as can dilatation of the superior ophthalmic veins.

Blood Cultures:

Positive culture bottle(s) 1. Streptococcus pneumoniae 

Pneumococcal meningitis/ventriculitis has been suspected based on the blood culture.