“Spitting Stones” and Broncholithiasis Caused by Mycobacterium chimaera in a Patient Affected by Bronchiectasis: A Rare Clinical Case

We describe the case of a 62-year-old woman with underlying bronchiectasis who referred to our respiratory outpatient clinic for hemoptysis and lithoptysis, in addition to difficulty gaining weight over years. Chest CT scan revealed small pulmonary nodules, bronchiectasis with mucus plugs, and calcifications, both endobronchial and peribronchial. Bronchial lavage fluid was positive for Mycobacterium (M.) chimaera. A daily macrolide-based triple antibiotic therapy, including rifampicin, ethambutol, and azithromycin, was started. Broncholithiasis associated with pulmonary nontuberculous mycobacterial infection is a rare clinical condition. To the best of our knowledge, this is the first report of broncholithiasis due to M. chimaera infection.