Cases (n=19) Clinical Fever not responding to 2nd-line antibiotics Cough   Pleuritic chest pain      Breathlessness   Hemoptysis   Abnormal CXR without fever   Hypotension Asymptomatic- just a rising GM   Sinusitis  Pleural effusion on CXR or CT    16 (84.7%) 8 (42.1%) 4 (21.1%) 5 (26.3%) 4 (21.1%) 1 (5.3%) 3 (15.8%) 1 (5.3%)* 1 (5.3%) 10 (52.6%) MRI brain Normal Abnormal#    Not done      7 (36.8%) 3 (15.8%) 9 (74.4%) Use of AmB or LAmB Not given Started as part of febrile neutropenia protocol  Started when IMD considered 3 (15.8%) 13 (68.4%) 3 (15.8%) Anti-fungal started when IMD considered@ AmB or Lamb Voriconazole Caspofungin Combination 3 (15.8%) 4 (21.1%) 3 (15.8%) 1 (5.2%) Further cycles of chemotherapy after IMD 0 ^ 0✔ 1 2 3 >3 2 (10.5%) 3 (15.8%) 1 (5.3%) 2 (10.5%) 6 (31.6%) 5 (26.3%) Delay in chemotherapy No delay   Delayed 2-4 weeks  Delayed >4 weeks 8 (42.1%) 3 (15.8%) 6 (31.6%) Eventual HSCT Yes, autologous     Yes, allogeneic    4 (21.1%) 4 (21.1%) # all MRI brain abnormalities were minor, none had infarct, mass, or abscess * 4 (21.1) did not have a rising GM; 14(73.7) were not monitored @in 8, amB or LAmB started as part of febrile neutropenia protocol was continued ^ not because of death but because the patients declined ✔includes the 2 who died in index admission (see text) and 1 who died at 3-month mark after discharge

Table 3: Clinical features of IMD in patients with acute leukemia.