A 76-year-old male, former smoker, suffering from COPD was referred for treatment. The patient reported with productive cough, worsening dyspnea, haemoptysis and yellowish-brown sputum. He had a past history of diabetes mellitus and hypertension. He also reported recent oral corticosteroid use for an exacerbation of COPD. On clinical examination the patient was found to have fever, tachycardia (with a heart rate of 166 beats per minute), reduced breath sounds and normal blood pressure.
Lab investigations revealed an elevated white blood cell count of 25×109 and a C-reactive protein (CRP) of 143 mg/l. · Chest X-ray displayed blunting of the left costophrenic angle. · CT scan showed multiple cavities in the lower left lobe. · Bronchoscopic examination revealed pus and mucosa inflammation. Sputum culture on Sabouraud Dextrose Agar exhibited a white colored, cotton candy like mould…
