A 65-year-old woman was admitted to a hospital in Mason City, Iowa, due to a two-month history of malaise and migraines that had been progressively worsening. She also reported vertigo, light sensitivity and blurred vision, hearing loss, and pulsatile tinnitus, although she did not report any fevers or chills. Her past medical history is notable for hypertension and smoking one pack of cigarettes per day. Her daughter owns hobby chicken coops, and the patient admits that she works with her daughter’s chickens. She was transferred to Mayo Clinic due to bilateral papilledema, elevated intercranial pressure, and elevated cell counts in cerebrospinal fluid (CSF). A Gram stain of CSF (pictured) shows lymphocytic pleocytosis (green arrows) and a cluster of organisms in the center.
|Sarah Jung, Ph.D.
Fellow, Clinical Microbiology
|Audrey Schuetz, M.D.
Senior Associate Consultant, Clinical Mirobiology
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine