| Summary points: | A 51-year-old African-American female with HIV infection presents with intermittent chills and fever, haemoptysis, pleuritic chest pain, dyspnoea, anorexia, malaise, and weight loss over the past 6 weeks. Physical examination, chest radiograph, computed tomography, and laboratory tests are described; images provided. The authors stress the need to consider invasive pulmonary aspergillosis in patients who are non-neutropenic, HIV infected with high CD4 count, who exhibit respiratory symptoms and lack response to standard antimicrobial therapy. |