Pulmonary Aspergillosis in the context of AML

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A 65 year old white woman with a history of refractory acute myeloid leukaemia (AML) that was resistant to chemotherapy developed probable pulmonary aspergillosis. She had neutropenia for 28 days pre-diagnosis, following recent chemotherapy and high-dose steroid use. Invasive aspergillosis was diagnosed from chest CT (nodules/consolidation) and consecutively positive antigen tests. She was refractory to itraconazole IV and amphotericin B (progression of disease) and was treated with caspofungin (70mg loading, then 50mg/day) for 29 days with stabilisation of her infection and further improvement was seen with oral itraconazole.

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Case history