The third patient was a 36-year-old HIV-infected woman with a 4-month history of bilateral skin lesions affecting the lower extremities (Figure) and 206 CD4 cells/mm3. HIV infection had been diagnosed 18 months earlier; baseline CD4 count was 6 cells/mm3. She began fixed-dose combination stavudine, lamivudine, and nevirapine soon after her HIV diagnosis. An incisional biopsy from the active margin of a leg lesion showed several foci of dermal necrosis with dense lymphocytic infiltrate and Langhans-type giant cells consistent with granulomatous inflammation of tuberculosis (Figure). Culture of biopsy material was positive for M. avium complex. The isolate reacted only with the M. avium-intracellulare-scrofulaceum complex probe of the INNO-LiPA reverse-line blot. The 16S rDNA gene and ITS sequences were identical to the M. avium complex ATCC 35770 (Melnick) strain sequences published by Boddinghaus et al. and available in the Ribosomal Differentiation of Microorganisms database (http://rdna.ridom.de). The ITS sequence was also identical to the MAC ATCC 35770 strain sequence available in GenBank (ITS sequevar MAC-D, accession no. L07851). The hsp65 sequence was identical to the ATCC 35770 sequence (accession no. U85637). Because the full 16S rDNA gene sequence of this strain was not available in GenBank and only a small fragment of hsp65 was available, we deposited our sequences under accession nos. EU815938 (16S rDNA) and EU935586 (hsp65). This patient was treated with azithromycin, 500 mg/day, ethambutol, 800 mg/day, and rifampin, 600 mg/day. Her lesions abated over the subsequent weeks, and she remained well as of follow-up in 2008.