Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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CASE REPORT
Year : 2016  |  Volume : 37  |  Issue : 2  |  Page : 185-189

Aspergillus meningoencephalitis in a patient with human immunodeficiency virus infection: Normal cerebrospinal fluid does not mean absence of meningitis


1 Department of Neurology, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India
2 Department of Medicine, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad, Anand, Gujarat, India
3 Department of Medicine, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

Correspondence Address:
Soaham Dilip Desai
Department of Neurology, Pramukh Swami Medical College and Shree Krishna Hospital, Karamsad - 388 325, Anand, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7184.188482

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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 grew Aspergillus after 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 CNS Aspergillus in the immunosuppressed.


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