Tsukamurella pulmonis Isolated in Sputum Culture During Workup for Tuberculosis: Colonization or Infection?

is a rare, opportunistic actinomycete most often associated with respiratory infections in immunocompromised patients. We report the case of a young immunocompetent man with a remote history of completely treated pulmonary tuberculosis, in whom was repeatedly isolated from sputum during routine screening. Despite these findings, the patient remained asymptomatic, with normal inflammatory markers and stable chest imaging, and therefore did not receive antimicrobial therapy. This case underscores the importance of correlating microbiological results with clinical and radiological assessments. It highlights that, in immunocompetent individuals, the presence of in respiratory cultures may represent colonization rather than true infection, and unnecessary antimicrobial treatment can be avoided with thorough evaluation.