A previously fit 66-year-old presented to hospital with a history of back pain, decreased level of consciousness and one grand mal seizure. She was ultimately found to have group B streptococcal infection with Streptococcus agalactiae thought to be secondary to spondylodiscitis, possibly secondary to latent infection from an abdominal hysterectomy performed 30 years previously. This case highlights the increasing incidence of group B streptococcal infection in nonperipartum adults, and the implications are discussed.

Pseudomonas septicaemia presenting with subcutaneous nodules, though rare, is well described in immuno-compromized populations. It is, however, very uncommon in immunocompetent patients. We describe a case of a 42-year-old woman who presented with community-acquired Pseudomonas aeruginosa septicaemia and subcutaneous nodules. No precipitating cause or immune dysfunction was found. She was successfully treated with appropriate antibiotics, respiratory and cardiovascular support in the Intensive Care Unit. The difficulty in eradicating the organism from the skin lesion and the need for investigating the immune function of septicaemia patients are discussed.

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