A 50 -year-old male patient with a long history of asthma and bilateral bronchiectasis with chronic respiratory failure, was discharged with oxygen supplementation and non-invasive ventilation. He was admitted to our department for an acute exacerbation of his asthma, apart from a fever evolving for six months. He had many episodes of minor hemoptysis leading to the suspicion of pulmonary embolism (PE). CBC showed anemia (hemoglobin = 9g/dl). He tested negative for COVID-19. CTPA excluded the presence of PE and showed a large cavity in the left upper lobe in direct contact with a 4mm RA. Sputum was positive for the acid-fast bacilli, as well as the culture for TB mycobacteria. There were no arguments for the diagnosis of chronic pulmonary aspergillosis. Aspergillus antibodies (precipitins) were negative. Thoracic imaging didn't show cavities with a fungal ball present or nodules on. We started antitubercular drugs. The patient showed rapid clinical and radiological improvement.