Cerebral cavernous malformation with secondary bacterial infection: illustrative case

This is the first documented case of a CCM secondarily infected by S. pneumoniae. It emphasizes the importance of considering infection in patients with known or suspected CCMs presenting with systemic or intracranial infection, particularly when imaging is atypical. Furthermore, this case provides insight into CCM biology: in KRIT1 mutations, impaired endothelial integrity may predispose lesions to inflammatory and infectious insults, supporting the concept that cavernomas are dynamic vascular malformations shaped by genetic, immune, and infectious interactions. https://thejns.org/doi/10.3171/CASE25628.