Non-tuberculous mycobacterial pulmonary infections

Pulmonary disease due to environmental mycobacteria (EM) occurs worldwide, and its prevalence has increased as a consequence of the HIV pandemic. It is not often detected in the tropics, owing to a lack of laboratory facilities, but when sought it has been found. In addition to HIV infection, certain occupations such as mining render the workforce more susceptible to disease and call for a revision of working conditions. Resolution by therapy can be achieved in many cases. As the prevalence of tuberculosis diminishes worldwide-and hopefully it will in the wake of the resurgence of interest and the widespread application of the World Health Organization's Directly Observed Therapy Short Course (DOTS) strategy-disease due to EM will become relatively more important and will necessitate revised strategies in clinical, microbiological, and public health approaches to mycobacterial disease.