title: A very unusual organism causing stroke-like symptoms.
abstract: A 78-year-old man presented to hospital with new onset confusion and fever. The working diagnosis was of delirium due to an infection of unknown source, and empirical i.v. antibiotic treatment was given. Two days later, he deteriorated and developed clinical features in keeping with a total anterior circulation stroke. Brain imaging was unremarkable. Blood cultures grew an organism subsequently identified as Facklamia languida. Following treatment with broad-spectrum antibiotics, his condition improved. A diagnosis of F. languida septicaemia, leading to presumed (unwitnessed) seizure and Todd's paresis was made. The patient went on to make a full recovery and was discharged home. Stroke mimics are common and may be eminently treatable. Around a quarter of patients initially suspected to have a stroke are subsequently found to have an alternative diagnosis.
authors.affiliation: Medicine for the Elderly, Monklands Hospital, Lanarkshire, UK.
authors.forename: Eve
authors.initials: E
authors.lastname: McCann
authors.affiliation: Medicine for the Elderly, Monklands Hospital, Lanarkshire, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Barber
authors.affiliation: Microbiology, Monklands Hospital, Lanarkshire, UK.
authors.forename: Pamela
authors.initials: P
authors.lastname: Hunter
authors.affiliation: Microbiology, Monklands Hospital, Lanarkshire, UK.
authors.forename: Donald
authors.initials: D
authors.lastname: Inverarity
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003221:Confusion / Q000382:microbiology; D003937:Diagnosis, Differential; D005334:Fever / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010243:Paralysis / Q000382:microbiology; D011237:Predictive Value of Tests; D021521:Ribotyping; D012640:Seizures / Q000382:microbiology; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D020521:Stroke / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Facklamia; older people; seizure; septicaemia; stroke; stroke mimic