To the editor: Serious infections with opportunistic fungi are occurring with greater frequency. They are not necessarily accompanied by fever nor does the patient have to appear acutely ill. New, effective drugs make accurate diagnosis important.
A 79-year-old woman was hospitalized with increasing somnolence of 1 week's duration. At age 75 she had had a marked loss of memory, episodes of disorientation, dullness, and generalized weakness. Six months before admission, pain and rigidity in the upper cervical area was followed by a grand mal seizure. The patient had recently acquired two parakeets.
She was an elderly, obtunded, chronically ill woman