Successful Treatment of Mycobacterium massiliense Lung Disease with Oral Antibiotics Only

Mycobacterium abscessus is the most drug-resistant mycobac-terial species (1, 2). Combination therapy with intravenous amikacin plus cefoxitin or imipenem and an oral macrolide for 2 to 4 months is recommended (3). Recently,M. abscessus was split intoM. abscessus sensu stricto,Mycobacteriummassiliense, andMy-cobacterium bolletii (4, 5). Effective therapy forM.massiliense lung disease remains elusive but still usually requires parenteral agents (6).We report a case ofM.massiliense lung disease thatwas treated successfully with oral antibiotics only. A 43-year-old woman was referred for cough, sputum, and hemoptysis. Computed tomography revealed severe bronchi-ectasis and peribronchial consolidation in both lungs (Fig. 1A to C). A sputum smear was positive for acid-fast bacilli, and all isolates (5 sputum specimens) were identified as M. massil-iense, using sequence analysis targeting the rpoB and hsp65 genes (6). Other bacterial and mycobacterial pathogens wer