This patient had severe kyphoscoliosis as a child with insertion of spinal rods in early adulthood. She is a life-long non-smoker. She first presented in 2001 with an irritating cough and several treatments with antibiotics failed to alleviate it.Aspergillus precipitin titre was high and she was initially diagnosed with chronic pulmonary aspergillosis with one cavity containing an aspergilloma. This patient developed resistance to all azole therapies.

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