Nontuberculous mycobacterial lung disease

Other Names: Non-tuberculous mycobacterial lung disease; Pulmonary non-tuberculous mycobacterial infection

Nontuberculous mycobacterial (NTM) lung disease is an infectious condition caused by certain types of mycobacteria. Nontuberculous mycobacteria (NTM) are mycobacteria other than M. tuberculosis (the cause of tuberculosis) and M. leprae (the cause of leprosy). NTM are also referred to as atypical mycobacteria, mycobacteria other than tuberculosis (MOTT), or environmental mycobacteria.

Source

NTM are environmental organisms that can be found in soil, dust, and water including natural water sources (such as lakes, rivers, and streams) and municipal water sources (such as water that people drink or shower in). NTM can form difficult-to-eliminate biofilms, which are collections of microorganisms that stick to each other, and adhere to surfaces in moist environments, such as the insides of plumbing in buildings.

Symptoms

NTMs can cause infections in a wide variety of body sites, most commonly the lungs and in the following areas:

• Skin and soft tissue (typically following surgery, trauma, injection of medications or other substances)
• Device associated infections (e.g., central line associated bloodstream infection, exit site infections, pacemaker pocket site infections, etc.)
• Lymph nodes (most commonly in children)
• Blood or other usually sterile locations in the body (disseminated) (most commonly in immunocompromised patients, such as those with HIV or AIDS, but may also be due to invasive medical devices or procedures)

Symptoms can be vague and nonspecific, such as:

• Fever
• Weight loss
• Night sweats
• Decreased appetite
• Loss of energy
• Other symptoms depend on the site of infection and can include cough, shortness of breath, blood in the sputum, and rashes.

Diagnosis

Diagnosis of opportunistic mycobacteria is made by repeated isolation and identification of the pathogen with compatible clinical and radiological features. Similar to M. tuberculosis, most nontuberculous mycobacteria can be detected microscopically and grow on Löwenstein-Jensen medium. Many reference centres now use a nucleic acid-based method such as sequence differences detection in the gene coding for 16S ribosomal RNA to identify the species. Pulmonary NTM disease diagnosis requires both identification of the mycobacterium in the patient's lung(s), as well as a high-resolution CT scan of the lungs.

Treatment

The condition is generally treated with a combination of antibiotics which is often continued until certain tests have been negative for 12 months. In some cases, surgery may be recommended if lung tissue is damaged.

NIH genetic and rare disease info

• NIH info on Nontuberculous mycobacterial lung disease

Nontuberculous mycobacterial lung disease is a rare disease.

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