ABSTRACT
Mycobacteria have in the past been known to infect the gastrointestinal tract. These infections involving Mycobacterium tuberculosis and Mycobacterium bovis gradually all but vanished in the developed nations of the world with the use of effective chemotherapy, public health measures, and tuberculin testing of dairy herds. Since 1982 a dramatic recurrence of mycobacterial infections of the gastrointestinal tract became apparent due to a hitherto unknown gastrointestinal pathogen, Mycobacterium avium-intracellulare. This unusual pulmonary pathogen, well-recognized in the southeastern U.S., had previously been recorded to have caused only 24 cases of disseminated mycobacterial disease. 1 Within five years of the onset of the human immunodeficiency virus (HIV) pandemic, M. avium-intracellulare (MAI) was noted to be the most common bacterial infection in this population of patients, 2 and is now the third most common opportunistic disease in the U.S. associated with the acquired immunodeficiency syndrome (AIDS). 3 Simultaneously, evidence for extrapulmonary tuberculosis has also increased in HIV+ individuals, being higher among parenteral substance abusers and persons born in Haiti, the Phillipines, Mexico, Central America, and Africa. 4
