Brief ReportsNot Just Homeless, Creutzfeldt-Jakob Disease A Case ReportPieroni, Jacopo MD*; Pecori, Alessio MD*; Imperiale, Daniele MD†; Maule, Simona MD*Author Information *Department of Medical Sciences, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino †Department of Neurology and Centre of Prion Disease, Maria Vittoria Hospital, Turin, Italy. Send reprint requests to Jacopo Pieroni, MD, Department of Medical Sciences, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Corso Bramante 88, Turin, Italy. E-mail: email@example.com. I confirm that all authors participated in drafting or revisiting the article approved the final version of the manuscript and agreed to conditions noted on the authorship agreement form. Specifically, J. P., A. P., and S. M. were involved in the patient clinical management; D. I. provided the neuropathological diagnosis; J. P. and A. P. wrote and edited the manuscript; and S. M. critically revised the manuscript. No other author contributed to this manuscript besides those named in the author list. The data reported have not been previously published, the article is not under simultaneous consideration by another journal and the authors have not published any related papers from the same study. This article has been previously submitted to and then rejected by two journals, Schizophrenia Bulletin and Psychiatric Services, because they do not accept case reports. Written informed consents were obtained from patient's relatives for publication of this manuscript and accompanying results. The Journal of Nervous and Mental Disease: May 2020 - Volume 208 - Issue 5 - p 435-438 doi: 10.1097/NMD.0000000000001136 Buy Metrics Abstract Over a 3-month period, a homeless person was admitted several times to emergency departments after displaying severe behavioral changes and paranoia. No psychiatric tests were performed but all other tests were repeatedly normal; antianxiety treatments or painkillers were the common outcome. It may seem that any diagnosis rested on the patient's immediately apparent social circumstances. Indeed, the patient was admitted to our internal medicine department after a diagnosis of acute delirium within a context of social disadvantage. This social predicament, namely, the patient's evident homelessness, proved to be a false but significant and overarching influence on several misdiagnoses until that moment. Subsequently, actual psychological observations, assessments and tests indicated and confirmed the presence of Creutzfeldt-Jakob disease. Creutzfeldt-Jakob disease is an uncommon and fatal disease; however, early diagnosis can enable the implementation of an important palliative care program. The starkly impoverished social circumstances of a patient should never distract a medical practitioner from a comprehensive diagnosis. Homelessness, for example, may invite certain physical and mental considerations, but it must not overdetermine our response and must not obscure or detract from a wider diagnosis. Homelessness is not a medical condition. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.