To the Editors:
Nontuberculous mycobacteria (NTM) are opportunistic pathogens that are widely present in our environment, i.e. in the soil and in natural and processed water. This group of organisms, with varying biological properties and clinical relevance, has gained notoriety over the past two decades due to their capability to cause severe disease in patients with immunodeficiency and/or chronic lung disease [1]. Despite their rising isolation frequency and growing clinical importance, NTM infections receive little scientific or public health attention. This partly results from the dogma that these NTM infections are not transmitted from male-to-male [1].
During our previous research of Mycobacterium malmoense infection in the Netherlands [2], we studied two patients with M. malmoense pulmonary infection with a strong epidemiological link. Human transmission was suspected because an acid-fast bacilli (AFB) smear-positive patient was in close contact with an immunocompromised patient. Herein, we present details of the cases and the results of the molecular diagnostics that were performed. The patients gave informed consent; ethical approval was not required for this retrospective study.
A 38-yr-old male with a medical history of chronic obstructive pulmonary disease and spontaneous pneumothorax reported to the respiratory physician with progressive dyspnoea, productive cough, fever, night sweats, malaise and weight loss. A chest radiograph revealed infiltrates with cavities in the upper lobes. Laboratory diagnostics showed a raised erythrocyte sedimentation rate (90 mm·h−1) and leukocytosis (white blood cell count …