Diagnosis of non-tuberculous mycobacterial pulmonary disease (NTM-PD): modern challenges

Abstract

Non-tuberculous mycobacterial pulmonary disease is growing in incidence and prevalence. However, it is frequently overlooked as a differential diagnosis by both clinicians and radiologists alike due to its non-specific clinical features, wide spectrum of radiological findings and difficulty in isolating the causative organism. The aim of this article is to illustrate the spectrum and follow-up of the radiological findings of non-tuberculous mycobacterial pulmonary disease and the challenges involved in making a diagnosis.

Disseminated Mycobacterium genavense infection in a guinea pig (Cavia porcellus): a case report

“…skin testing, imaging, tracheal washes) would not be acceptable in this situation. In cases of non-tuberculosis mycobacterial pulmonary disease in humans, diagnosis depends on compatible clinical and radiographic findings along with positive sputum samples or positive culture results from bronchial lavage [27,28]. Unfortunately, tracheobronchial lavage is not considered a routine procedure in guinea pigs due to their small size and laryngeal anatomy, limiting our diagnostic capabilities to noninvasive diagnostics such as CT [29].…”

Case studies to illustrate good practice in the management of non-tuberculous mycobacterial pulmonary disease

“…Although most are clinically insignificant, several species of NTM can cause pulmonary disease in humans (NTM-PD), which remains a challenging condition for healthcare providers to diagnose and manage [ 4 ]. Several risk factors for NTM-PD have been identified, including demographic characteristics, medical conditions, structural lung diseases, an abnormal immune response, and drug treatments [ 1 , 2 , 4 , 5 ] ( Table 1 ).…”

“…1 ). However, for several reasons, this is not always straightforward [ 5 ]. Firstly, its presentation and ongoing symptoms are non-specific, and may be obscured by pre-existing lung conditions such as bronchiectasis, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF).…”

“…Secondly, NTM are ubiquitous in the environment and can transiently colonise the airways without causing disease [ 1 , 4 ]. Thirdly, chest X-rays may appear normal, near-normal or non-specifically abnormal [ 5 ] which can result in NTM-PD being missed or misdiagnosed ( Fig. 2 ) [ 2 , 5 ].…”

“…Thirdly, chest X-rays may appear normal, near-normal or non-specifically abnormal [ 5 ] which can result in NTM-PD being missed or misdiagnosed ( Fig. 2 ) [ 2 , 5 ]. More recently, a biomarker of NTM-PD (serum anti-glycopeptidolipid-core IgA) has been identified, which may aid in the diagnosis of NTM-PD [ 7 ].…”