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A 75-year-old male with chronic obstructive pulmonary disease (COPD) (on inhaled fluticasone/umeclidinium/vilanterol and intermittent intravenous methylprednisolone) presented with a 4-week history of intermittently productive cough and mucoid sputum. He denied fever, weight loss or haemoptysis. The patient had a 40-pack-year smoking history but no diabetes, haematological malignancies or tuberculosis. Physical examination revealed bilaterally reduced breath sounds. Laboratory tests showed mild anaemia (haemoglobin 114 g/L) and elevated C-reactive protein (21.4 mg/L). Serum galactomannan and cryptococcal antigen tests were negative.