Diabetes mellitus and air crescent sign.

A 66-year-old gentleman, presented with history of fever and cough for 2 weeks. He was a known case of diabetes mellitus type 2 for five years. He was febrile, had tachypnea, trachycardia and 96% oxygen saturation at room air. Chest auscultation revealed crackles in bilateral infrascapular area. Chest x-ray was within normal limit. Diagnosis of communityacquired pneumonia was made, he was admitted, and started on levofloxacin along with insulin therapy. On day three of therapy his condition worsened. CT-chest images showed bilateral lung consolidation with air lucency in between. Serum galactomannan was 5.5ng/mL. Bronchoalveolar lavage grew septate acute branching hyphae, proven to be Aspergillus on polymerase chain reaction (PCR). He was started on injection liposomal amphotericin.