Aspergillosis

QUESTION 72

A 78-year-old man with a history of acute myeloid leukemia (AML) currently on induction chemotherapy was admitted to the hospital for the evaluation of fever and chills. He was neutropenic at the time of admission (with white blood cells [WBC] less than 0.5 × 10⁹/L). Despite prompt initiation of broad-spectrum antibiotics, he became progressively hemodynamically unstable with hypotension and tachycardia and was subsequently intubated for acute hypoxic respiratory failure. Laboratory work-up demonstrated elevated lactic acid and serum inflammatory markers, but blood cultures drawn daily were all negative. On the third day of his hospital stay, the intensive care team consulted dermatology for evaluation of a necrotic lesion on the neck. On examination, there was a necrotic plaque on the right neck with surrounding erythema (72a

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