A 43-Year-Old Man Undergoes Induction Chemotherapy for Acute Myeloid Leukemia

A 43-year-old man undergoes induction chemotherapy for acute myeloid leukemia.  Three weeks later, he is hospitalized with fever, cough, and generalized weakness.  On physical examination, his temperature is 38.1 C (100.7 F) , blood pressure is 102/68 mm Hg, and pulse is 125/min.  The patient's pulse oximetry shows 95% on room air.  Crackles are heard over the right upper lung.  His hemoglobin level is 9.5 g/dL, and leukocyte count is 900/mm³ with an absolute neutrophil count of 100/mm³.  Chest x-ray reveals a dense infiltrate involving the right upper lung lobe.  Broad-spectrum antibiotic therapy is instituted.  Five days later, the patient is still febrile.  Bronchoscopy with biopsy is performed and the tissue samples from the bronchoscopy grow mold.  Which of the following organisms is most likely responsible for this patient's current condition?

A) Aspergillus fumigatus
B) Candida albicans
C) Cryptococcus neoformans
D) Pneumocystis jirovecii
E) Rhizopus oryzae

Correct Answer:

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