Patient 1 was an 82‐year‐old man with a history of COPD and pharyngeal cancer who was transferred to the ICU on hospital day 3 for acute respiratory distress syndrome (ARDS) and septic shock. He was afebrile at Aspergillus isolation on hospital day 15, but respiratory status deteriorated with increased FiO2 from 50% to 80%. A chest radiograph showed worsening bilateral infiltrates. He was initially treated with cefepime and vancomycin. Voriconazole was added 3 days after the first positive culture for Aspergillus. Leukocytosis persisted on broad‐spectrum antibiotics and voriconazole. He developed intermittent fever with worsening respiratory status and required continued vasopressor support. The family subsequently requested no further aggressive treatment, and he passed away 17 days after the initiation of antifungal therapy.