A 40-year-old female presented with fever and cough which had lasted for 3 months. Three years previously systemic lupus erythematosus had been diagnosed, and at that time 10mg of prednisone per day was prescribed. Crackles were heard at the base of the lung and her chest roentgenogram revealed diffuse infitrates in both lower lung fields. Despite of empirical antibiotics and antituberculous medication consisting of iosniazid, rifampicin and ethambutol, the patients condition deteriorated. We performed open lung biosy and numerous nodules with necrosis as well as acid fast bacilli were observed. After biochemical tests and sequencing , the organism was identified as Mycobacterium abscessus. The patient was treated with imipenem and amikacin; patients condition, as indicated by both symptoms and roentogenogram, subsequently improved.