Fig 1.

Algorithm of the DDAT approach for the management of PFN in patients with hematological malignancies and HSCT recipients proposed by the SAEI. TSCT, thin-section computed tomography; BAL, broncoalveolar lavage; GM, galactomannan antigen test; CT, computed tomography; CNS, central nervous system; US, ultrasound; AP, alkaline phosphatase; BC, blood cultures; AT, antifungal therapy. L-AMB, liposomal amphotericin B. “Voriconazole, L-AMB*”: voriconazole and L-AMB are used when Mucor spp. infection is suspected. Three boxes are marked with asterisks as follows. “Caspofungin, voriconazole, L-AMB**”: caspofungin, voriconazole, and/or liposomal amphotericin are the antifungal therapy of choice if Aspergillus, Scedosporium, or Fusarium sp. is suspected. “No AT indication*”: in patients who have neither severity signs nor clinical focus of fever, antifungal therapy is not initially indicated, and close clinical monitoring and further diagnostic tests are performed as clinically indicated until there is PFN resolution or a change in any of the above conditions.