Nontuberculous mycobacterial pulmonary disease (NTM-PD) is increasingly prevalent [1] and especially common in the elderly [2]. It is usually chronic, requiring complex therapy with suboptimal outcomes [3]. Risk factors for NTM-PD may be covert, presumably disordered mucociliary defences, or overt structural lung abnormalities. In one study, 56% of NTM-PD patients had unexplained nontuberculous mycobacteria (NTM) and among the rest with structural lung disease, chronic obstructive pulmonary disease (COPD) was the most common predisposing condition [4].