case_images: PMC5985606_01
case_images: CT head showing left and right mastoid air cell effusion.
case_images: 10.1177_2050313X18775584-fig1.jpg
case_images: PMC5985606_01_10.1177_2050313X18775584-fig1.jpg
case_images: fig1-2050313X18775584
case_images: 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).
case_images: Gram stain showing Gram-positive bacteria in chains.
case_images: 10.1177_2050313X18775584-fig2.jpg
case_images: PMC5985606_01_10.1177_2050313X18775584-fig2.jpg
case_images: fig2-2050313X18775584
case_images: 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).