Abstract
The diagnosis of pulmonary nontuberculous mycobacteria (NTM) disease may be challenging,
as their presence alone does not necessarily indicate disease and diagnosis requires
the integration of clinical, radiological, and microbiological findings. The first
step is to suspect NTM disease; however, clinical manifestations of NTM are nonspecific
and it may not be possible to separate them from those caused by underlying respiratory
disease. The radiological appearance generally falls into two patterns, fibrocavitary
disease and nodular-bronchiectatic disease; consolidation, infiltrates, and solitary
nodules are also described. The isolation of NTM from clinical samples is fundamental
to the diagnosis and they may be cultured from sputum, bronchoalveolar lavage fluid,
or tissue specimens. If sputum is used, more than one isolate is required for diagnosis
due to the propensity of NTM to contaminate clinical samples. The correct identification
of NTM is vital, as their clinical relevance varies widely between species, and treatment
is dictated by the identity of the isolated organism. This review covers the clinical
presentation of NTM disease, the interpretation of radiological findings, and issues
surrounding the isolation and identification of mycobacteria.
Keywords
nontuberculous mycobacteria - diagnosis - microbiological findings
