Clinical and radiologic criteria (all required) |
1. Pulmonary or systemic symptoms |
and |
2. Nodular or cavitary opacities on chest radiograph or bronchiectasis with multiple small nodules on high-resolution computed tomography |
and |
3. Appropriate exclusion of other diagnoses |
Microbiologic criteria (at least one required)* |
1. Positive culture results from at least two separate expectorated sputum samples. If the results are nondiagnostic, consider repeat sputum AFB smears and cultures. |
or |
2. Positive culture result from at least one bronchial wash or lavage. |
or |
3. Transbronchial or other lung biopsy with mycobacterial histopathologic features (granulomatous inflammation or AFB) and positive culture for NTM; or biopsy showing mycobacterial histopathologic features (granulomatous inflammation or AFB) and one or more sputum or bronchial washings that are culture positive for NTM. |
Additional considerations |
- Expert consultation should be obtained when NTM are recovered that are infrequently encountered or that usually represent environmental contamination.
- Patients who are suspected of having NTM lung disease but do not meet the diagnostic criteria should be followed until the diagnosis is firmly established or excluded.
- Making the diagnosis of NTM lung disease does not, per se, necessitate the institution of therapy, which is a decision based on potential risks and benefits of therapy for individual patients.
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