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Invasive pulmonary aspergillosis — SCE Respiratory MCQ

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HardRespiratory InfectionsInvasive pulmonary aspergillosisSCE Respiratory

A 48-year-old renal transplant recipient presents with fever, pleuritic pain and nodular lung infiltrates with halo signs on CT. He is neutropenic after treatment for rejection. Serum galactomannan is positive and sputum culture grows Aspergillus fumigatus. What is the most appropriate management?

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Correct answer: A — Voriconazole and urgent immunosuppression review

Invasive aspergillosis is likely in this immunosuppressed neutropenic patient with halo-sign nodules and positive galactomannan, and voriconazole is standard first-line therapy with immunosuppression review. Amoxicillin does not cover Aspergillus. Observation would be dangerous because untreated invasive disease progresses rapidly.

Reference: IDSA Aspergillosis Guideline; BNF Voriconazole