https://www.selleckchem.com/products/brigatinib-ap26113.html Polyarteritis Nodosa (PAN) is a small and medium vessel necrotizing vasculitis that can affect any system in the human body. Rarely, PAN can be the primary manifestation of an underlying malignancy. The association between malignancy and vasculitis is an ongoing topic of research. Our patient's presentation suggests malignancy may be a trigger for acute onset vasculitis and therefore once a malignancy is identified, therapy should be targeted towards treating the malignancy rather than the vasculitis alone. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.A 35-year-old male of Asian ethnicity presented with complaints of high-grade fever, severe headache, vomiting, generalized seizures, deteriorated conscious level and neck stiffness. After all baseline workup Computed Tomography (CT) scan of the brain was done, which turned out to be unremarkable. CT scan was then followed by lumbar puncture (LP) and Cerebrospinal fluid (CSF) detailed report was sent, which was highly suggestive of bacterial meningitis with the predominance of polymorphonuclear leukocytes. Later on, CSF culture and sensitivity report showed growth of Escherichia coli, which is one of the rare causes of meningitis in immunocompetent adults without any history of craniocerebral trauma, neurosurgical intervention, urinary or gastrointestinal tract infections, and an immunocompromised state. Abbreviations CSF Cerebrospinal fluid; LP Lumbar puncture; CT Computerized tomography; E-coli Escherichia coli; GCS Glasgow coma scale; COPD Chronic Obstructive Pulmonary Disease; HTLV1 Human T-Lymphotropic virus -1; PCR Polymerase chain reaction. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Introduction Streptococcus pneumoniae endocarditis (SPE) occurs in less then 3% of all EI ca