PMC5985606_01
CT head showing left and right mastoid air cell effusion.
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Computed tomography (CT) of head done in the Emergency Department for possible stroke revealed a left mastoid effusion and an interval development of right mastoid air cell effusion (Figure 1).
Gram stain showing Gram-positive bacteria in chains.
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The patient had 4/4 blood cultures with growth of Gram-positive cocci in chains which was later speciated to S. pyogenes and also had growth from the CSF culture of heavy growth with streptococcus group A (Figure 2).