This field shows examples of gram-positive bacteria in pairs, often referred to as diplococci. These are lancet shaped "diplococci" which could represent Streptococcus pneumoniae. Although the Gram stain is characteristic of S. pneumoniae, the determination of bacterial species always requires confirmatory testing. This particular image is a direct Gram stain prepared from a sputum specimen and not organisms recovered from culture. The large gram-negative, red to pink staining rounded structures in the background are polymorphonuclear (PMN) leukocytes.