PMC7202353_01
A) CT scan. In the left lung is present a 20 mm excavation filled with fluid: air-crescent sign. B) CT scan of the abdomen. Two hypodensae cystic hepatic lesions of 2 and 1.5 cm; other millimetric lesions can be seen (white arrows). C) Brain MRI: T2 weighted sequence. An 11 mm cystic lesion is present in the left head of the caudate nucleus, with compression of the left lateral ventricle. Mild peri-lesional edema is present. D) Brain MRI: T1 weighted gadolinium contrast-enhanced sequences. The same cystic lesion showing a concentric rim of contrast.
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Later, when neutropenia recovered, the CT-scan showed the evolution of the lung nodule into a cavitary lesion (Figure 1A), multiple liver abscesses (Figure 1B), and a single brain abscess in the left head of the caudate nucleus (Figure 1C-D).
CT scan after 8 months from S. capitata infection. A) In the left lung is present a 7 mm excavation scar (white arrow). B) CT scan of the abdomen. Shrunken hypodensae cystic hepatic lesion of 11 mm. C) Brain CT: A 9 mm cystic lesion surrounded by concentric rim is present in the left head of the caudate nucleus.
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Eight months later, AML is in complete remission, and fungal infection is improving on isavuconazole (Figure 2), despite the prolonged neutropenia induced by the consolidation cycles.