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Conclusions: The Early Warning Score significantly underestimated how unwell the patient was upon arrival in ED, a systems-based assessment would have demonstrated that the patient had multiple system dysfunction and significant potential to deteriorate suddenly despite having stable observations The methotrexate level has no clinical value in diagnosing or refuting a diagnosis of methotrexate toxicity A full examination of the immunosuppressed patient including ENT is a necessity when searching for a source of infection Invasive fungal infections can cause multi-system symptoms and atypical presentations As a greater proportion of patients have received systemic immunosuppression for Covid-19, vigilance for more unusual pathogens, including Mucormycosis by clinicians is advised

Classically, necrotrophs are thought to kill the host using various phytotoxins, cell wall degrading enzymes, and reactive oxygen species that are secreted into the host tissues

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doi: 10.3390/ijms231911746 134 MajTWangWCrespoJZhangHWangWWeiSet al

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