A 71 year-old man with severe COPD (not on steroids) presented with one week of a non-productive cough, fever and dyspnea. His exam revealed crackles and egophony over the right upper lobe (RUL). The chest X-ray confirmed a community acquired pneumonia (CAP), and he was started on Azithromycin. His symptoms did not improve. A chest CT showed extension of the RUL consolidation, but no cavities or endobronchial lesions. Blood and sputum gram stain, AFB, KOH, and cultures were negative, except one sputum with branching hypae, which was dismissed as a contaminant. Fluconozole and Vancomycin were added, but his condition worsened. Acute renal failure occurred on day seven. Bronchoscopy was performed on day eight, and revealed black mucus and white nodules within the bronchioles. Lavage and biopsies were negative for organisms or cancer. The patient died from an acute lung hemorrhage on day ten. Autopsy revealed invasive Aspergillus Niger with an acute lung hemorrhage. DISCUSSION: A progressive CAP despite antibiotic therapy implies one of the following: the wrong antibiotic selection, a post-obstructive pneumonia (POP), a fungal pneumonia, immunosuppression, alveolar proteinosis or BOOP. In our patient the acute presentation, imaging studies without fleeting infiltrates, and bronchoscopy without obstruction were clues against BOOP, alveolar proteinosis, and POP. The patient's brisk immune response, severe COPD and negative bacterial cultures were important hints towards a fungal infection. Although Aspergillus pneumonia usually occurs in the immunocompromised, it can occur in immunocompetent patients so the presence of branching hyphae on cultures should not be disregarded as colonization or contamination when a clinical pneumonia is present, especially in those with chronic diseases. Empiric Amphotericin B and lung biopsy should be considered when clinical evidence suggests Aspergillus since cultures and even bronchoscopy are frequently negative. This patient had Aspergillus Niger which produces oxalic acid creating a pathognomonic black acidic sputum and an immune mediated glomerulonephritis. Sputum and BAL cultures are positive in less than 10% and dissemination occurs in 25% of patients.