Abstract
We present a previously well woman in her 70s who was admitted for 2 weeks of progressively worsening abdominal pain, high fever and drowsiness. She was eventually diagnosed withClostridium septicumbrain abscess, meningoencephalitis and ventriculitis. The diagnosis was challenging as cerebrospinal fluid cultures were negative and a microbiological diagnosis was only obtained on brain biopsy. Despite early initiation of antibiotics that would have been effective againstC. septicum, her central nervous system (CNS) infection progressed, and she eventually succumbed to the infection. Infections withC. septicumare typically fulminant and associated with high mortality. In a patient with a CNS infection and concomitant abdominal manifestations, infection withC. septicumshould be considered.