Scedosporium infection disseminated “from toe to head” in ... - BMC Infectious Diseases
The patient is a 65-year-old female who was diagnosed with unfavorable risk AML [with TP53 mutation and del(5q)] in April 2022. She was refractory to standard induction therapy but responded to a combination of a hypomethylating agent and venetoclax (3 cycles). She remained neutropenic throughout and after treatment, and received prophylaxis with fluconazole 400 mg daily for 3 months until her transplant, due to concern for elevated liver enzymes previously with posaconazole. She was neutropenic upon admission for alloHCT [white blood cells (WBC) 0.81 × 10 9 /L and absolute neutrophil count (ANC) 0.62 × 10 9 /L]. Her pre-transplant chest computerized tomography (CT) revealed irregular nodular opacities, therefore posaconazole 300 mg daily was re-challenged on admission (day -6). On day + 5, she was switched to micafungin 150 mg daily with concern for transaminitis. On day + 6, she developed hypoxemia, and had a worsening RUL nodular opacity on chest ...