A 26-year-old Caucasian female at 18 weeks of gestation and a history of CF with Delta G551D mutation on Ivacaftor, a CF Transmembrane Conductance Regulator (CFTR) potentiator, was found to have recurrent admissions to the hospital with exacerbations of her pulmonary symptoms of cough and purulent sputum production, dyspnea on exertion, pleuritic chest pain and small amount of hemoptysis. The vital signs were stable except for a low grade fever of 99.5  F. Blood cultures were negative, but she was known to harbor multi-drug resistant Pseudomonas aeruginosa, Methicillin Resistant Staphylococcus aureus (MRSA), Achromobacter species and Aspergillus fumigatus in her bronchial airways, and had been treated multiple times in the past for these infections. She was not on any immunosuppressive drugs and did not have any other medical problems. Her chest radiograph revealed bilateral diffuse reticulonodular opacities which had remained stable over the past two years (Fig. 1). She had been treated for pulmonary tuberculosis three years ago, with a regimen that included Isoniazid (INH), Rifampin (RIF), Ethambutol (EMB) and Pyrazinamide (PZA) in the intensive phase for two months, followed by four months of INH and RIF in the continuation phase. Her sputum cultures after completion of therapy were negative for MTB. Two sputum cultures during the current admission revealed MTB, but on genotype analysis, it was found to be a different MTB strain from the one she had before, pointing towards reinfection after successful completion of antitubercular treatment. Drug susceptibility testing showed sensitivity to all first-line drugs (INH, RIF, EMB, PZA). Due to her pregnancy, she was given a three drug regimen of INH, RIF and EMB for nine months. Her repeat sputum cultures were negative for MTB six weeks after therapy was initiated. She tolerated the regimen well with an improvement in her symptoms and delivered a full term male fetus without any complications. The patient was lost to follow-up after completion of therapy and all efforts to contact her thereafter were unsuccessful.