Diagnosis and Treatment of Disease Caused by Nontuberculous Mycobacteria

Abstract

Diagnostic Criteria of Nontuberculous Mycobacterial Lung Disease For patients with a cavitary infiltrate: Two or more sputums or bronchial washings that are acid-fast bacilli smear positive and/or produce moderate to heavy growth on culture.Exclusion of other reasonable causes for the disease.II. For patients with a noncavitary infiltrate: Two or more sputums or bronchial washings that are acid-fast bacilli smear positive and/or produce moderate to heavy growth on culture.The isolate is Mycobacterium avium complex or M. kansasii and cannot be cleared from the sputum with either bronchial hygiene or 2 wk of drug therapy.Exclusion of other reasonable causes for the disease.For patients with a cavitary or noncavitary infiltrate whose sputum evaluations are nondiagnostic or another disease cannot be excluded: 1. Lung biopsy yields a NTM.2. The biopsy shows mycobacterial histopathologic features (i.e., granulomatous inflammation) and two or more sputums are positive for a NTM even in low numbers.