Uploaded August 2026 | Updated September 2026, 1 week ago
A 61-year-old man with prolonged neutropenia as a result of salvage chemotherapy for acute myeloid leukemia was evaluated on hospital day 37 for persistent neutropenic fever despite treatment with broad-spectrum antimicrobial agents. Physical exam was notable for a lesion with central necrosis on the chest and a similar lesion on the left palm. A serum 1,3-β-D-glucan level was elevated, and a galactomannan was negative. Computed tomography of the chest, abdomen, and pelvis was performed. Gram’s staining of blood culture revealed septate, hyaline hyphae.
What is the most likely causative organism? Submit your answer at NEJM.org.
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A 61-year-old man with prolonged neutropenia as a result of salvage chemotherapy for acute myeloid leukemia was evaluated on hospital day 37 for persistent neutropenic fever despite treatment with broad-spectrum antimicrobial agents. Physical exam was notable for a lesion with central necrosis on the chest and a similar lesion on the left palm. A serum 1,3-β-D-glucan level was elevated, and a galactomannan was negative. Computed tomography of the chest, abdomen, and pelvis was performed. Gram’s staining of blood culture revealed septate, hyaline hyphae.
What is the most likely causative organism? Submit your answer at NEJM.org.
#nejm
