Nontuberculous%20mycobacterial%20disease Signs and Symptoms

Signs and Symptoms

Introduction

Nontuberculous mycobacterial (NTM) pulmonary diseases are ubiquitous & are usually found in soil, natural & treated water sources
- Relatively uncommon cause of pulmonary disease
- Likely to cause disseminated disease except Mycobacterium kansasii which causes lung infection w/o dissemination among HIV-coinfected patients w/ low CD4 counts
May cause both asymptomatic infection & symptomatic disease in humans
There is no evidence of animal-to-human or human-to-human transmission in immunocompetent hosts
NTM pulmonary disease is a generally slowly progressive infection

Etiology

M avium complex (MAC) is the most common NTM species causing pulmonary disease in the US
- Includes at least 2 mycobacterial species: M avium & M intracellulare
- M intracellulare is the more common respiratory pathogen
- Commonly found in indoor water systems, pools & hot tubs
M kansasii & M abscessus are the 2nd & 3rd most common pulmonary pathogen, respectively

Signs and Symptoms

Generally nonspecific
Chronic or recurring cough w/ sputum production
Dyspnea, chest pain
Fatigue, malaise, weightt loss, fever, hemoptysis
May be complicated by symptoms caused by coexisting lung diseases

Risk Factors

Hot tub exposure
Older men who are smokers, older women w/ no smoking history
Excessive alcohol use
Co-existing illnesses: chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumoconiosis, prior tuberculosis (TB), esophageal motility disorders, pulmonary alveolar proteinosis, malignancy
There is an association between bronchiectasis, nodular NTM pulmonary disease & specific body type especially postmenopausal women (eg pectus excavatum, scoliosis, mitral valve prolapse, joint hypermobility)

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