IGHE and asthma: We describe an 11-year-old girl with difficult-to-treat asthma and recurrent pneumonias (three episodes within one year) in whom comprehensive evaluation revealed borderline total IgE (678 IU/mL), <i>Aspergillus</i>-specific IgE of 5.81 kUA/L, high-resolution CT demonstrating bilateral infiltrates with scattered nodules, and <i>Aspergillus fumigatus</i> identification via bronchoalveolar lavage fluid culture and targeted next-generation sequencing (tNGS).