Pulmonary non-tuberculous mycobacterial disease

We confirmed 3 and identified 7 possible cases of pulmonary non-tuberculous mycobacterial disease. The clinical and radiological features were indistinguishable from those of tuberculosis, although a few thin-walled cavities may have been more suggestive of non-tuberculous disease. Previously described predisposing factors were identified in our patients and included previous fibrocavitating disease, chronic airflow obstruction and bronchiectasis. However, 5 patients had no pre-existing lung disease. The difficulties in treating these patients are discussed and in view of the chronic indolent course, prolonged aggressive polypharmacy is usually not indicated. It is recommended that at least two consecutive sputum specimens be sent for culture and drug resistance testing whenever the disease is suspected. This will help differentiate colonisation from infection and rationalise management.