Case Series – Clinical 3

1. A 15 year old male patient with B-ALL presented with high grade fever and severe mucositis after high dose methotrexate therapy. He was admitted and broadspectrum antibiotics were started and serum procalcitonin was sent. On examination painless subcutaneous erythematous nodules were noted some of which were necrotic. His Absolute Neutrophil count (ANC) was < 200 and serum procalcitonin came out to be 0.2. Fever didn't respond to broad spectrum antibacterials. Chest CT was not s/o Fungal lesion. Likely etiology in this scenario could best be diagnosed by:- ( serum 1,3-b-D glucan = s-BDG and serum galactomannan index = s-GMI)

Question 1 of 2

2. Which of the following will produce best response in this patient ?

Question 2 of 2


Ref:  How we treat invasive fungal diseases in patients with acute leukemia: the importance of an individualized approach. Blood. 2014 Dec 18;124(26):3858-69


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