Good morning, @meningone Oh my goodness, you’ve sure had your share of some serious medical conditions. I read through some earlier posts to see that you also had Bacterial Meningitis which has left you with continual pain, and some chronic intestinal issues as well. And now you have this rare bacterial lung infection.

Streptomyces bacteria are abundant in soil, ironically known for their production of antimicrobial substances, and are rarely reported to cause infection. Except, as you mentioned, in immunocompromised people such as someone with HIV, Crohn’s disease, sarcoidosis, etc.. So now you’re wondering how this happened and why.

From your previous posts you have a lot of inflammation and pain. Science and research has shown our gut biome has a great deal to do with our overall health. The gut is intricately connected to the immune system. It houses up to 70 percent of the immune system cells. It regulates the immune system response in addition to its regular digestive duties.
I found a really good article that breaks down the relationship between health and the gut which you might find helpful.
https://goodmenproject.com/featured-content/gut-health-how-it-affects-the-immune-system/
So with your chronic intestinal issues, this may have left you with a compromised immune system and more susceptible to infections. Are you on any immunosuppressant medications? Certain medications can also play a part in reducing the immune response.
How you contracted the streptomyces is a mystery. Do you work with soil, do a lot of gardening, raking decaying leaves, farm work/manure?

What are your current medications for the infection? Now that it’s been identified has your doctor discussed a long term treatment plan?