Case 257

Case 257

Medical History

A 17-year-old female patient with systemic lupus erythematosus undergoing chemotherapy for macrophage activation syndrome. Neutropenic since 4 weeks ago, neutrophils = 0-50 / uL, maintaining fever despite broad spectrum antibiotic therapy (antibacterials + antifungals), with no associated symptoms. She presented a positive serum test of galactomannan. Two computed tomography (CT) scans of the thorax were performed at intervals of one month between them, which are shown below.

 


Question:
Based on the clinical data and test results, what is the most likely diagnosis?

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