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<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 200%; text-align: justify;"><span style="mso-ansi-language: EN-GB; mso-bidi-font-weight: bold;" lang="EN-GB"><span style="font-size: small;"><span style="font-family: Times New Roman;">An 8-year old boy, affected by severe aplastic anemia, developed<span style="mso-spacerun: yes;"> </span>a probable pulmonary invasive aspergillosis (IA) early after a second unrelated allogeneic hematopoietic stem cell transplant (HSCT). He was treated promptly with the combination of liposomal amphotericin B and caspofungin. Despite the initial stabilization, the patient deteriorated and the antifungal therapy was switched to voriconazole and caspofungin. The patient gradually improved and was discharged home on day +29 post-HSCT on oral voriconazole. <span style="mso-spacerun: yes;"> </span>On day +119, a sudden episode of hemoptysis occurred and a right superior lobectomy was decided to remove the residual aspergilloma. The patient is now alive and well more than 24 months from HSCT. This case demonstrated that antifungal combination therapy and surgery are valid options to cure pulmonary IA even in patients at high-risk and severely immunosuppressed.<span style="mso-spacerun: yes;"> </span></span></span></span></p>