title: Aspergillosis of the central nervous system in a previously healthy patient that simulated Creutzfeldt-Jakob disease.
abstract: BACKGROUND
  The presence ofAspergillusin the central nervous system (CNS) is rare in immunocompetent patients but not in immunocompromised patients who may have a more common infection. This article describes a case of an adult immunocompetent patient with a diagnosis of cerebral aspergillosis and with a clinical process of rapidly progressive dementia which simulated a Creutzfeldt-Jakob syndrome.
  
  
  METHODS
  A 34-year-old adult was previously healthy and had no medical history of any significance. The patient had suffered only facial trauma 8 months before admission. One month prior to admission, he showed rapidly progressing changes in his behavior and higher mental functions. He was admitted to the emergency room with an occipital headache with 2 months of history. By the time he arrived, he suffered from total disability and was prostrate. He was diagnosed with meningeal and demential syndrome in the process of being studied. After starting the diagnostic approach by investigating cerebrospinal fluid, a magnetic resonance of the skull, an electroencephalogram, a brain biopsy was indicated. The histopathological study reported the presence of the hyphae characteristics ofAspergillus. The patient died 7 days after the diagnosis.
  
  
  CONCLUSIONS
  Cerebral aspergillosis is a common aggressive disease in immunosuppressed patients. However, the disease is rare in individuals with respected immunity and in individuals with neurological impairment and a rapid and progressive deterioration of mental functions. The suspected diagnosis should always be considered given its poor prognosis and the encouraging efficacy of antifungal treatment administered in a timely manner.
authors.affiliation: Department of Neurosurgery, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: Adrián
authors.initials: A
authors.lastname: Santana-Ramírez
authors.affiliation: Department of Neurosurgery, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: Sergio V
authors.initials: SV
authors.lastname: Esparza-Gutiérrez
authors.affiliation: Department of Neurosurgery, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: Pedro
authors.initials: P
authors.lastname: Avila-Rodríguez
authors.affiliation: Department of Internal Medicine, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: J Eugenio
authors.initials: JE
authors.lastname: Jiménez-Gómez
authors.affiliation: Department of Pathology, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Vélez-Gómez
authors.affiliation: Department of Neuroradiology, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
authors.forename: David
authors.initials: D
authors.lastname: Bañuelos-Gallo
keywords: Cerebral aspergillosis; Creutzfeldt-Jakob; dementia syndrome; meningeal syndrome; spongiform encephalopathy; upper motor neuron syndrome