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Pulmonary aspergillosis (PA) is a well-described complication in severely immunocompromised hosts. We report on one case of invasive PA and one case of PA following oral dexamethasone prophylaxis for cerebral oedema. Steroids were administered in a dosage of 14 mg and 16 mg, daily respectively for 21 and 15 days. Both patients died despite antifungal treatment. We conclude that PA must be considered as a cause for pulmonary complications in non-immunosuppressed, non-neutropenic patients during oral dexamethasone prophylaxis for neurological disease.