The present article will review our current understanding of nontuberculous mycobacterial pulmonary disease with particular emphasis on pathogenesis, diagnosis, and therapeutic decision making. Areas of clinical controversy in which current data are inadequate to guide our decision making will be highlighted.
A 50-year-old man who had been dependent on home parenteral nutrition (HPN) for 24 years presented with shortness of breath. A computed tomography scan of the lungs revealed a diffuse micronodular parenchymal infiltrate. On bronchoscopy, a crystalloid material was identified. This organic material was determined to be consistent with codeine. The patient had been injecting codeine into his intravenous catheter.
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