Nontuberculous mycobacteria in women, young and old

The spectrum of nontuberculous mycobacteria (NTM) lung disease has been increasingly appreciated in patients without predisposing factors, especially in middle-aged to elderly women, and termed Lady Windermere syndrome. The awareness and understanding by physicians of this entity has been limited. Recent studies have revealed distinct anatomic and physiologic abnormalities, and they have set off the understanding of its immunopathogenesis. A less common manifestation of pulmonary disease caused by NTM, hot-tub Mycobacterium avium complex, more often occurs in younger women and also is discussed here.