• Eve McCann, Mark Barber, Pamela Hunter, and Donald Inverarity.
• Medicine for the Elderly, Monklands Hospital, Lanarkshire, UK.
• Age Ageing. 2014 Sep 1; 43 (5): 727-8.

AbstractA 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. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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