Summary
Definition
History and exam
Key diagnostic factors
- underlying lung disease
- chronic productive cough
- dyspnoea
- weight loss
- fatigue
- fever
- lymphadenopathy
- immunocompromised
- hot tub use
Other diagnostic factors
- age under 5 years
- middle-to-old age
- night sweats
- abdominal pain
- diarrhoea
- rhonchi/crackles
- hepatomegaly
- splenomegaly
- thin body habitus
- pectus excavatum
- scoliosis
- systolic click and murmur
Risk factors
- underlying lung diseases
- smoking
- excessive alcohol use
- increasing age
- hot tub use
- HIV/AIDS
- severe immunosuppression
- genetic cytokine defects
Diagnostic investigations
1st investigations to order
- FBC with differential
- LFT
- chest x-ray
- sputum culture
- blood culture
Investigations to consider
- high-resolution CT (HRCT) scanning
- bone marrow aspirate for culture
- bronchoscopy/bronchial lavage
- lung biopsy
- lymph node biopsy
Treatment algorithm
Contributors
Authors
Zelalem Temesgen, MD, FIDSA
Professor of Medicine
Director, Mayo Clinic Center for Tuberculosis
Director, HIV Program
Consultant, Division of Infectious Diseases
Mayo Clinic
Rochester
MN
Disclosures
ZT declares that he has no competing interests.
Acknowledgements
Dr Temesgen would like to gratefully acknowledge Dr Dereje S. Ayo, a previous contributor to this topic.
Disclosures
DSA declares that he has no competing interests.
Peer reviewers
Jonathan P. Parsons, MD
Assistant Professor
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
Ohio State University Medical Center
Columbus
OH
Disclosures
JPP declares that he has no competing interests.
Sandro Vento, MD
Director
Infectious Diseases Unit
Annunziata Hospital
Cosenza
Italy
Disclosures
SV declares that he has no competing interests.
References
Key articles
National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Disseminated mycobacterium avium complex disease. 2024 [internet publication]Full text
Griffith DE, Aksamit T, Brown-Elliott BA, 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.Full text Abstract
Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Clin Infect Dis. 2020 Aug 14;71(4):e1-36.Full text Abstract
Haworth CS, Banks J, Capstick T, et al. British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax. 2017 Nov;72(suppl 2):ii1-64.Full text
Reference articles
A full list of sources referenced in this topic is available here.
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