Mr. Knox is a 22-year-old male undergoing chemotherapy treatment for Acute Myeloid Leukemia. He was seen in clinic last week for chemotherapy, and he was relieved to see that his neutrophil count was back up above 1 (ANC 1000). He had no evidence of bleeding, and his platelet count was 110. He tolerated his intravenous chemotherapy and anti-emetics well, and went home to recover for the weekend. Eight days later, Jesse is feeling unwell and checks his temperature as he has been taught to do – it reads 38.5 deg C orally, so he presents to the ER as instructed. Apart from the fever, his only complaint is a sore mouth. He denies cough, shortness of breath, dysuria or change in bowel movements. Physical exam reveals a tired and pale-looking young man. His blood pressure is 105/60, heart rate 125 bpm, respiratory rate 18 and a temperature of 38.9 deg C. His tongue has a white coating and his gums look sore. His central line catheter site appears clean.