Aspergillus and Mucormycosis

The image displays a macroscopic view of a fungal colony growing on an organic substrate. Based on its characteristic appearance, which of the following organisms is most likely depicted?

A 52-year-old man with poorly controlled diabetes mellitus (HbA1c 11.2%) presents with acute onset of facial swelling, black necrotic lesions on the hard palate, and fever. Imaging shows invasion into the maxillary sinuses. KOH mount reveals broad, non-septate hyphae. What is the drug of choice for this condition?

A 35-year-old woman with chronic granulomatous disease (CGD) develops persistent cough, hemoptysis, and nodular infiltrates on chest X-ray. Sputum culture grows *Aspergillus fumigatus*. She has no evidence of invasive disease. What is the drug of choice for chronic pulmonary aspergillosis in this immunocompromised host?

A 58-year-old man with chronic obstructive pulmonary disease (COPD) and recent oral corticosteroid use presents with a 3-week history of productive cough with hemoptysis, low-grade fever, and weight loss. High-resolution CT chest shows a cavitary lesion in the right upper lobe with a mobile opacity (fungal ball) inside the cavity. Sputum microscopy is negative for acid-fast bacilli. What is the most appropriate next step in management?

A 42-year-old immunocompromised patient (CD4 count 35 cells/μL) with chronic pulmonary symptoms develops a fungal ball in the upper lobe cavity. Chest X-ray shows a mobile opacity within the cavity with surrounding halo sign. Which is the most common causative organism of aspergilloma?