Abstract
We report a 69-year-old with a past medical history of prostate cancer, and arsenic poisoning, who was incidentally found to have multiple pulmonary nodules and hepatosplenic lesions on CT imaging. He denied respiratory symptoms, but was noted to have significant weight loss. A bronchoscopy revealed mycobacterium kumamotonense on culture. He was treated presumptively for pulmonary and disseminated infection with azithromycin and ethambutol for 16 months, and 12 months of rifabutin after four months of rifampin which was discontinued due to resistance. Patient's weight loss resolved and CT imaging appeared significantly improved.