February 2023 Medical Image of the Month: Reversed Halo Sign in the Setting of a Neutropenic Patient with Angioinvasive Pulmonary Zygomycosis

No abstract available. Article truncated after 150 words. A 66-year-old man presented to our emergency department with fever and lethargy. CBC demonstrated profound neutropenia an absolute neutrophil count of <0.50x109 cells/L (critically low). The patient was admitted workup for febrile begun. patient’s past medical history includes CLL (recently confirmed be in remission by bone marrow biopsy), hypogammaglobulinemia/capillary leak syndrome (presumably related obinutuzumab therapy, which receives monthly IVIG), coccidioidomycosis (for the has been followed infectious disease at institution, is on fluconazole). An outpatient chest CT performed 1 week prior presentation follow up pulmonary nodules a few scattered small, but new, inflammatory-appearing (Figure 1A, 2A). repeat time admission, 7 days initial CT, marked interval increase size small nodules, now represented as large areas mass-like consolidation including …