In March 2009, a 7-year-old female patient with CF presented with a history of increased cough, increased sputum production, and fever for 5 days. Auscultation of the chest revealed new crackles throughout her left lung. An oropharyngeal culture was obtained, from which the microbiology laboratory results showed growth of a gram-negative organism on oxidation-fermentation-polymyxin-bacitracin-lactose medium. Subculture on selective media led to a presumptive identification of B pseudomallei on a VITEK 2 (bioMérieux; Durham, North Carolina) automated instrument. Additional oropharyngeal and induced sputum samples were obtained on March 31, 2009, and April 1, 2009, respectively, and each grew organisms identified as B pseudomallei by VITEK 2. BAL was not considered necessary at this time because of three positive throat and sputum cultures and new findings on auscultation. The bacterium was susceptible to imipenem, ceftazidime, and doxycycline. The original isolate was categorized as resistant to trimethoprim/sulfamethoxazole (TMP/SMX) with a minimal inhibitory concentration (MIC) of 4/76. Subsequently this isolate was reported as sensitive by the US Centers for Disease Control and Prevention (CDC) (MIC, 2/38).