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An association between Mycobacterium malmoense and underlying lung disease has been described. The purpose of this study was to further explore this relationship and in particular to identify any relationship between Coal Workers' Pneumoconiosis (CWP) and M. malmoense infection. Patient charts were reviewed of all patients who had a positive sputum or bronchoalveolar lavage for M. malmoense from 1999 to 2006 in a large district general hospital in South Yorkshire, UK. We also performed a literature review in search of this association; one case report was found. Four patients had positive sputum cultures for M. malmoense but only three of these fulfilled the ATS 1997 criteria for diagnosis of disease. Of these three patients, all had clinical and radiologic evidence of CWP. This study strengthens the evidence of a link between nontuberculous mycobacteria and underlying lung disease but more importantly highlights an association between M. malmoense and CWP which has been rarely reported and is poorly understood.

While the prevalence of Mycobacterium tuberculosis continues to decline in the developed world, the same cannot be said for non-tuberculous mycobacteria (NTM). These organisms are increasing in incidence and prevalence throughout the world. This is probably because of a combination of increased exposure, improved diagnostic methods and an increase in the prevalence of risk factors that predispose individuals to infection. Considerable confusion can arise in determining in the wide range of species whether an isolated NTM is in fact a contaminant or a pathogenic organism when isolated in sputum or bronchoalveolar lavage. This confusion combined with increasing requests for advice on the treatment of disease has led to the development of guidelines to assist the clinician in diagnosing and treating infection accurately.