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Nontuberculous Mycobacterial Infection
Nontuberculous Mycobacterial Infection
Kyung Soo Lee, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Nontuberculous mycobacteria (NTMB)
                • Nontuberculous mycobacterial infection (NTMBI)
                • Mycobacterium avium complex (MAC)

              • Synonyms

                • Mycobacteria other than tuberculosis (MOTT)
                • Lady Windermere syndrome
                  • Initial description of nodular bronchiectatic NTMBI

              • Definitions

                • Pulmonary infection with NTM
                  • Synonyms: Environmental mycobacteria, atypical mycobacteria, MOTT
                  • No person-to-person transmission (isolation of affected patients not required)
                  • Acquired from environmental sources (pipeline water supply and contaminated soil)
                  • Indolent and slowly-progressive disease

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Diagnosis

                                • Natural History and Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Anjos LRBD et al: Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings. Rev Soc Bras Med Trop. 53:e20200241, 2020
                                      2. Chin KL et al: Pulmonary non-tuberculous mycobacterial infections: current state and future management. Eur J Clin Microbiol Infect Dis. 39(5):799-826, 2020
                                      3. Daley CL et al: Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Clin Infect Dis. 71(4):e1-36, 2020
                                      4. Cowman SA et al: Diagnosis of nontuberculous mycobacteria lung disease. Semin Respir Crit Care Med. 39(3):343-50, 2018
                                      5. Kwon YS et al: Diagnosis and treatment of nontuberculous mycobacterial lung disease. J Korean Med Sci. 31(5):649-59, 2016
                                      6. Henkle E et al: Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 36(1):91-9, 2015
                                      7. Lee SH et al: Detection and assessment of clarithromycin inducible resistant strains among Korean Mycobacterium abscessus clinical strains: PCR methods. J Clin Lab Anal. 28(5):409-14, 2014
                                      8. Lee G et al: Serial CT findings of nodular bronchiectatic Mycobacterium avium complex pulmonary disease with antibiotic treatment. AJR Am J Roentgenol. 201(4):764-72, 2013
                                      9. Lee G et al: Nodular bronchiectatic Mycobacterium avium complex pulmonary disease. Natural course on serial computed tomographic scans. Ann Am Thorac Soc. 10(4):299-306, 2013
                                      10. Kim HS et al: Serial CT findings of Mycobacterium massiliense pulmonary disease compared with Mycobacterium abscessus disease after treatment with antibiotic therapy. Radiology. 263(1):260-70, 2012
                                      11. Koh WJ et al: Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease. Chest. 142(6):1482-8, 2012
                                      12. Hsiao CH et al: Clinicopathologic characteristics of nontuberculous mycobacterial lung disease in Taiwan. Diagn Microbiol Infect Dis. 68(3):228-35, 2010
                                      13. Prevots DR et al: Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems. Am J Respir Crit Care Med. 182(7):970-6, 2010
                                      14. Park HY et al: Comparison of clinical and radiographic characteristics between nodular bronchiectatic form of nontuberculous mycobacterial lung disease and diffuse panbronchiolitis. J Korean Med Sci. 24(3):427-32, 2009
                                      15. Griffith DE et al: An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007 Feb 15;175(4):367-416. Review. Erratum in: Am J Respir Crit Care Med. 175(7):744-5, 2007
                                      16. Martinez S et al: The many faces of pulmonary nontuberculous mycobacterial infection. AJR Am J Roentgenol. 189(1):177-86, 2007
                                      17. Chung MJ et al: Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. Eur Radiol. 16(9):1934-41, 2006
                                      18. Jeong YJ et al: Nontuberculous mycobacterial pulmonary infection in immunocompetent patients: comparison of thin-section CT and histopathologic findings. Radiology. 231(3):880-6, 2004
                                      19. Koh WJ et al: Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 3(3):145-57, 2002
                                      20. Rickman OB et al: Hypersensitivity pneumonitis associated with Mycobacterium avium complex and hot tub use. Mayo Clin Proc. 77(11):1233-7, 2002
                                      21. Gangadharam PR: Microbiology of nontuberculosis mycobacteria. Semin Respir Infect. 11(4):231-43, 1996
                                      22. Reich JM et al: Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The Lady Windermere syndrome. Chest. 101(6):1605-9, 1992
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Nontuberculous mycobacteria (NTMB)
                                                    • Nontuberculous mycobacterial infection (NTMBI)
                                                    • Mycobacterium avium complex (MAC)

                                                  • Synonyms

                                                    • Mycobacteria other than tuberculosis (MOTT)
                                                    • Lady Windermere syndrome
                                                      • Initial description of nodular bronchiectatic NTMBI

                                                  • Definitions

                                                    • Pulmonary infection with NTM
                                                      • Synonyms: Environmental mycobacteria, atypical mycobacteria, MOTT
                                                      • No person-to-person transmission (isolation of affected patients not required)
                                                      • Acquired from environmental sources (pipeline water supply and contaminated soil)
                                                      • Indolent and slowly-progressive disease

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • Nuclear Medicine Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Diagnosis

                                                                    • Natural History and Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Anjos LRBD et al: Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings. Rev Soc Bras Med Trop. 53:e20200241, 2020
                                                                          2. Chin KL et al: Pulmonary non-tuberculous mycobacterial infections: current state and future management. Eur J Clin Microbiol Infect Dis. 39(5):799-826, 2020
                                                                          3. Daley CL et al: Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Clin Infect Dis. 71(4):e1-36, 2020
                                                                          4. Cowman SA et al: Diagnosis of nontuberculous mycobacteria lung disease. Semin Respir Crit Care Med. 39(3):343-50, 2018
                                                                          5. Kwon YS et al: Diagnosis and treatment of nontuberculous mycobacterial lung disease. J Korean Med Sci. 31(5):649-59, 2016
                                                                          6. Henkle E et al: Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 36(1):91-9, 2015
                                                                          7. Lee SH et al: Detection and assessment of clarithromycin inducible resistant strains among Korean Mycobacterium abscessus clinical strains: PCR methods. J Clin Lab Anal. 28(5):409-14, 2014
                                                                          8. Lee G et al: Serial CT findings of nodular bronchiectatic Mycobacterium avium complex pulmonary disease with antibiotic treatment. AJR Am J Roentgenol. 201(4):764-72, 2013
                                                                          9. Lee G et al: Nodular bronchiectatic Mycobacterium avium complex pulmonary disease. Natural course on serial computed tomographic scans. Ann Am Thorac Soc. 10(4):299-306, 2013
                                                                          10. Kim HS et al: Serial CT findings of Mycobacterium massiliense pulmonary disease compared with Mycobacterium abscessus disease after treatment with antibiotic therapy. Radiology. 263(1):260-70, 2012
                                                                          11. Koh WJ et al: Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease. Chest. 142(6):1482-8, 2012
                                                                          12. Hsiao CH et al: Clinicopathologic characteristics of nontuberculous mycobacterial lung disease in Taiwan. Diagn Microbiol Infect Dis. 68(3):228-35, 2010
                                                                          13. Prevots DR et al: Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems. Am J Respir Crit Care Med. 182(7):970-6, 2010
                                                                          14. Park HY et al: Comparison of clinical and radiographic characteristics between nodular bronchiectatic form of nontuberculous mycobacterial lung disease and diffuse panbronchiolitis. J Korean Med Sci. 24(3):427-32, 2009
                                                                          15. Griffith DE et al: An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007 Feb 15;175(4):367-416. Review. Erratum in: Am J Respir Crit Care Med. 175(7):744-5, 2007
                                                                          16. Martinez S et al: The many faces of pulmonary nontuberculous mycobacterial infection. AJR Am J Roentgenol. 189(1):177-86, 2007
                                                                          17. Chung MJ et al: Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. Eur Radiol. 16(9):1934-41, 2006
                                                                          18. Jeong YJ et al: Nontuberculous mycobacterial pulmonary infection in immunocompetent patients: comparison of thin-section CT and histopathologic findings. Radiology. 231(3):880-6, 2004
                                                                          19. Koh WJ et al: Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 3(3):145-57, 2002
                                                                          20. Rickman OB et al: Hypersensitivity pneumonitis associated with Mycobacterium avium complex and hot tub use. Mayo Clin Proc. 77(11):1233-7, 2002
                                                                          21. Gangadharam PR: Microbiology of nontuberculosis mycobacteria. Semin Respir Infect. 11(4):231-43, 1996
                                                                          22. Reich JM et al: Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The Lady Windermere syndrome. Chest. 101(6):1605-9, 1992