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Sepsis of unknown origin can be a difficult scenario whereupon careful balance needs to be struck between managing a deteriorating patient and choosing investigations carefully to uncover the aetiology. This case highlights a 70-year-old man with neutropenic sepsis of an unusual cause that is described on a key image from a CT scan. The patient was treated with medical management in favour of surgery in view of his relative frailty, and he had a good outcome. We expound on key clinical pearls for managing this condition.