Occult Cerebral Aspergillosis Presenting with Focal Status Epilepticus in an Immunocompetent Patient

Anil Ramineni

doi:10.15226/2374-6858/2/1/00115

Abstract

Occult Cerebral Aspergillosis Presenting with Focal Status Epilepticus in an Immunocompetent Patient

Highlights

Invasive aspergillosis is classically viewed as a disease of the immunocompromised patient
SC, a 64-year-old man, sustained a moderate traumatic brain injury resulting in a depressed left parietotemporal skull fracture which was treated neurosurgically via cranioplasty
He was transferred to our institution after 1 week for further medical evaluation. He was minimally arousable to noxious stimulation, non-verbal, moving all extremities with hyperreflexia and a Babinski sign present on the right side. He was placed on continuous EEG monitoring which revealed complex periodic discharges involving the left parietotemporal region concerning for nonconvulsive status epilepticus

Summary

Introduction

Invasive aspergillosis is classically viewed as a disease of the immunocompromised patient. SC, a 64-year-old man, sustained a moderate traumatic brain injury resulting in a depressed left parietotemporal skull fracture which was treated neurosurgically via cranioplasty. Post-operatively, he received one week of seizure prophylaxis with phenytoin and was discharged without event. The patient was afebrile, his laboratory studies including HIV were normal, and blood cultures had no growth. An MRI scan of his head without contrast demonstrated evidence of post-operative changes near his cranioplasty site, but no acute abnormality.

Results

Conclusion