65 year old male with past medical history of hypertension for which he has been taking Lisinopril. Patient was recently diagnosed with Acute Myeloid Leukemia and he received a full course of Cytarabine plus Idarubicin and G-CSF.

14 days post chemotherapy he presented with fever and weakness, his physical examination was completely normal and his WBC was 0.2. Patient was started on ceftazidime and vancomycin , blood cultures were negative, chest X-ray with no active infiltrates and bone marrow was hypocellular.

Patient continued to have fever and weakness over the next 3 days despite antibiotic coverage and he started having swelling in the right eye associated with discharge, he empirically started on Amphotericine and the following is a photograph taking 7 days post presentation (hover mouse to see CT scan of the sinuses).