Rapidly Progressive Dementia After Platelet-Rich Plasma Therapy: A Case of Sporadic Creutzfeldt-Jakob Disease in the Context of Chronic Ehrlichiosis.

Prion diseases are fatal neurological disorders characterized by the accumulation of abnormal proteins in the central nervous system, leading to rapid neurodegeneration. We present a male his 70s who developed rapidly progressive dementia three weeks after a routine platelet-rich plasma (PRP) injection for chronic hip pain. MRI revealed multifocal cortical diffusion restriction involving the basal ganglia. CSF analysis via real-time quaking-induced conversion (RT-QuIC) confirmed prion disease, with elevated T-tau and 14-3-3 gamma proteins. He also tested seropositive for Ehrlichia, though other infectious causes were ruled out. Despite treatment with IV immunoglobulins (IGs) and antibiotics, his condition declined with worsening myoclonus and hyperreflexia. He died one week after discharge to hospice, six weeks after symptom onset. This case demonstrates several classic clinical features of sporadic Creutzfeldt-Jacob disease (sCJD) and raises the possibility that an acute inflammatory response from PRP injection may have triggered sCJD in the setting of a pre-existing chronic inflammatory state from tick-borne infection.