Patients who use immunosuppressive agents, in particular
medication that blocks tumour necrosis factor-a, are at risk for mycobacterial infections. Besides the typical Mycobacterium tuberculosis i nfection, a lso a typical
mycobacterial disease may occur. Here we demonstrate
two patients with such atypical mycobacterial infection due
to swimming and fishing water contact. We propose that
patients, before starting with immunosuppressive therapy,
are counselled about risk factors for mycobacterial disease.