Description
An 84 year old man was admitted through the emergency department after being found collapsed at home. He had a temperature of 38.4oC and was hypotensive with a blood pressure of 82/57mmHg, but he was alert and orientated (GCS 15). He denied any symptoms suggesting a specific focus of infection – there were no murmurs or other findings suggestive of endocarditis and examination of the spine, limbs, nervous system and urine was unremarkable. He had previously had several basal cell carcinomas removed from his scalp with subsequent skin grafts. One skin graft was unsuccessful and an ulcer persisted with purulent discharge from the base. As no other source of infection was apparent, an urgent CT scan of the head was undertaken to investigate this ulcer further.
