Penicillin remains the mainstay of treatment. Although treatment has to be tailored to the individual, generally 18 to 24 million units of IV penicillin per day are given for 2 to 6 weeks followed by oral therapy with penicillin V (or amoxicillin) for 6 to 12 months in severe cases, while milder cases without fistulous tracts can be treated with oral penicillin for 3 to 6 months. In general, the thoracic form appears to require longer treatment courses compared to the other more common forms. Acceptable alternatives to penicillin include tetracyclines, erythromycin, and clindamycin. Surgery remains an important therapeutic adjunct that is particularly useful if there are complications, such as well-defined abscesses and empyemas with discharging fistulas and sinuses, or, in rare instances, to control life-threatening hemoptysis that can occur with infection, as in our patient.11,19 Our patient is doing well 1 year after undergoing surgery.