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A 45-year-old man was admitted for relapse of acute promyelocytic leukemia nine months after the first remission. Severe neutropenia had developed after salvage chemotherapy with mitoxantrone, cytarabine, and all-trans -retinoic acid and was complicated by invasive pulmonary aspergillosis. The patient initially received antifungal treatment with amphotericin B, followed by five months of treatment with itraconazole after his blood count had returned to normal. The patient was afebrile and had no clinical signs of pulmonary disease; his only symptom was a cough that produced yellowish-brown sputum in which Aspergillus fumigatus mycelia was persistently present. A chest x-ray film (Panel A) . . . [Full Text of this Article] |
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