Resected pulmonary Achromobacter xylosoxidans mimicking aspergillosis fungus ball

Achromobacter xylosoxidans, a rare gram-negative rod, often causes pneumonia. Here, we describe the case of a previously healthy 78-year-old woman who worked at a vegetable plant nursery. A 4.5-cm cavitary lesion with a 2.5-cm-diameter lobulated nodule in the left lingula segment, resembling an aspergillosis fungus ball, was coincidentally detected on chest computed tomography. Bronchoscopic culture eventually revealed A. xylosoxidans, which was sensitive to penicillin; however, the infection did not respond to oral antibiotics. Thus, surgical resection is likely to be indicated for A. xylosoxidans infection that mimics aspergillosis.