title: Aspergillusmeningoencephalitis in a patient with human immunodeficiency virus infection: Normal cerebrospinal fluid does not mean absence of meningitis.
abstract: A male with human immunodeficiency virus infection presented with febrile encephalopathy followed by seizures and left hemiparesis. Initial imaging with contrast computerized tomography (CT) scan brain and cerebrospinal fluid (CSF) examination were normal. Subsequent magnetic resonance imaging brain revealed bilateral parieto-occipital infarcts with bleed. He did not improve on treatment with broad-spectrum antibiotics, anti-tubercular drugs, and antifungals. He finally succumbed to the disease. His CSF culture grewAspergillusafter 2 weeks. Central nervous system (CNS) aspergillosis can present with variable presentations, and initial CT scan and CSF examination can be normal, especially in the immunosuppressed. High index of suspicion is required for the diagnosis of invasive CNSAspergillusin the immunosuppressed.
authors.affiliation: Department of Neurology, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India.
authors.forename: Soaham Dilip
authors.initials: SD
authors.lastname: Desai
authors.affiliation: Department of Medicine, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India.
authors.forename: Sanket
authors.initials: S
authors.lastname: Seth
authors.affiliation: Department of Medicine, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India.
authors.forename: Aniketh
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Medicine, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India.
authors.forename: Bhalendu
authors.initials: B
authors.lastname: Vaishnav
keywords: Aspergillosis; human immunodeficiency virus; meninigoencephalitis