Overwhelming fatal infection in a young woman after intravenous cyclophosphamide therapy for lupus nephritis.

We describe the case of a 19-year-old woman who died of overwhelming aspergillosis 3 months after receiving intravenous (IV) cyclophosphamide for progressive lupus nephritis. Her history is instructive because it illustrates the wisdom of strict adherence to the National Institutes of Health protocol for this treatment, specifically, the contraindication to use of IV cyclophosphamide when other immunosuppressive therapy has recently been employed.