NTM: Diagnosis

A nontuberculous mycobacterial (NTM) diagnosis can be more difficult to establish than a tuberculosis (TB) diagnosis.

It is important for your health care provider to determine if the infection is TB or NTM because the treatment is different. If it is NTM, the specific species of NTM is also important. Because these organisms are abundant in the environment, we require more than one positive sample to be consistent with disease. In addition, it is critical for the health care provider to determine whether the NTM infection requires treatment. Some people harbor the germs and remain well. They may need to be observed without treatment. Others develop symptoms consistent with progressive illness.

A diagnosis is often based on the following:

• Other procedures, such as bronchoscopy, may be required in certain cases.

• Based on the results of the tests your doctor can determine a diagnosis and the best treatment for you.

• A complete medical history and physical examination by a health care provider (often a pulmonary doctor).

• A Chest CT scan (a specialized X-ray, which produces detailed slide-like pictures) of the lungs.

• A sputum culture. Several sputum cultures are often necessary and must be done at specialized labs. One positive test does not always mean disease is present. In people that are not productive on their own, we strongly encourage a sputum “induction” (using hypertonic saline) before proceeding to bronchoscopy.