Skip main navigation

Haematology oncology patient – continued

Adilia Warris continues the case of an 8 year old boy diagnosed with high risk acute lymphatic leukaemia and developed fever (38.7°C).

In step 3.3, we introduced the case of an 8-year-old boy who was previously diagnosed with high risk acute lymphatic leukaemia and had developed a fever while being neutropenic during the induction phase of his treatment. Read below for the next part of the case and share your thoughts in the comments section.

The HRCT-thorax showed characteristic signs of a possible fungal infection, e.g. the dense nodule in the left lung on HRCT demonstrates the radiological ‘halo sign’, consistent with invasive pulmonary aspergillosis.

HRCT-thorax showing a dense nodule in periphery of left lung

Due to the high likelihood of an invasive fungal infection, presumed to be caused by Aspergillus species due to positive GM in serum, a BAL was performed.

Direct microscopy of the BAL-fluid showed septated hyphae compatible with Aspergillus species but the culture remained negative. GM index in BAL fluid was 1.6.

Answer the following questions in the comment section below:

  1. What does the GM test result in the BAL fluid tell you?
  2. What is your diagnosis using the EORTC-MSG definition guidelines?
  3. Which antifungal(s) would you prescribe?
  4. Is there an indication to perform any additional diagnostic test(s)?
This article is from the free online

Fungal Diagnostics in Critically Ill Patients

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education