A man who suffered from a bloody cough that persisted for more than a year was surprised to find that the cause was a giant ball of fungus growing in his lung, according to a recent report of his case.

The man, a farmworker in Italy, may have contracted a fungal infection, called aspergilloma, while working in the fields. For a year, he struggled with not only the cough but also fever and weight loss. His symptoms hadn’t improved despite several courses of antibiotics, according to the report published Oct. 24 in the journal BMJ Case Reports.

Aspergilloma, a fungal infection that mainly infects the lungs, is relatively uncommon, and this particular clump of fungus was extremely large, at nearly 3 inches (7.6 centimeters) wide.