Cocci that occur in pairs are referred to as diplococci. Image 4 contains many gram-positive diplococci.
Image 4. Examples of gram-positive diplococci. Lancet-shaped gram-positive diplococci from a lower respiratory tract specimen could indicate Streptococcus pneumoniae. Organisms that may be harbored in the upper respiratory tract gain access to the alveolar spaces by aspiration or inhalation. Image 5 is a Gram stain made from a lower respiratory tract specimen. The gram-positive diplococci can be presumptively identified as Streptococcus pneumoniae.
Image 5. Lower respiratory Gram stain with gram-positive diplococci.