16th August 2024

A 32-year-old man with a history of type 1 diabetes is brought to the Emergency Department in status epilepticus

A 32-year-old man with a history of type 1 diabetes is brought to the Emergency Department in status epilepticus. He responds to a loading dose of levetiracetam and does not require general anaesthesia.

Postictally, he is confused and disorientated to time, place, and events. On general examination, you note small lacerations with surrounding erythema on the dorsum of the left hand and localised left sided axillary lymphadenopathy. There is no meningism.

His partner reports that he had been feeling generally lethargic for several days but had become abruptly confused and listless in the last 12 hours. There is no recent travel history but they do have a cat at home.

A CT head is unremarkable, and a lumbar puncture demonstrates only a very mild lymphocytic pleocytosis.

Which is the single most likely causative organism?

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