23rd May 2024

A 75-year-old gentleman has a history of weight loss of 3 stone over 4 months and loss of appetite

A 75-year-old gentleman has a history of weight loss of 3 stone over 4 months and loss of appetite. He presents with fever, headache, drowsiness and lethargy. His wife thinks he has irritable bowel disease as he suffers from constipation and diarrhoea without any triggers. He appears cachectic, febrile, drowsy and unable to answer your questions. He has a diastolic murmur. He has some red papules on his hands. CT head shows 3 ring enhancing lesions which MRI confirms to be abscesses. Blood test shows Hb: 90g/L, MCV: 70, WCC: 15 x10⁹, neutrophils:13 x 10⁹.

What is the likely organism causing this presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.