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A 19-year-old woman underwent five cycles of chemotherapy for acute myelomonocytic leukemia that had been diagnosed 7 months earlier. During the last cycle of chemotherapy, neutropenia developed, lasting 22 days, during which she had fever that was treated with empirical antibacterial therapy. When the neutrophil count increased, the fever persisted. Her evaluation was notable for a peak temperature of 39.5°C and an increase in the serum alkaline phosphatase level to 335 U per liter. An abdominal computed tomographic (CT) scan showed multiple hypodense lesions in the liver and spleen findings that were consistent with hepatosplenic microabscesses (Panel A, arrows). . . . [Full Text of this Article] |