C) with negative blood cultures. Pseudomonas aeruginosa and Staphylococcus aureus were then isolated in the tracheal aspirate, being both ciprofloxacin sensitive. Patient persisted fe brile after seven days of antimicrobial therapy, and the previous germs were both once again isolated in the tracheal aspirate. Anaerobic gram positive cocci disposed in chains were identified in the blood culture; piperacilin and tazobactan for ciprofloxa cin resistant pseudomonas were introduced, with favorable outcome. Seven weeks after the stroke, patient started with low grade fever and local swelling over the decompressive craniotomy. Brain CT revealed a multiloculated hypodense lesion over the previously infarcted area, with mass effect and peripheral enhancement after contrast injection (Figs 2A and B), suggesting cerebral abscess. Eritrocyte sedimentation rate was elevated and blood count showed microcytosis and hypocromia, with mild leukocytosis and left shift. Transesophagic echocardiography revealed no abnormalities, similar to the one performed on admission. By means of a small skin incision, abscess punture was performed, with drainage of 40 ml of purulent secretion whose culture in anaerobic media revealed gram negative cocci organized in chains, identified as group C Streptococcus sp. Patient was treated with vancomycin and imipenem for 10 weeks, showing good response. She remains hemiparetic, but follows commands and articulates words. The area of cranial decompression became flacid, and con trol CT showed the infarcted territory still containing the enhanced abscess capsule. The bone flap, which had been kept transitorially in the subcutaneous fat of the abdomen, was replaced 12 months after the stroke, and the tomographic control demonstrated the left encephalomalatic area with complete resolution of the abscess (Fig 3).