Page 7 - NTM Insight Pamphlet 2024

HOW IS NTM DIAGNOSED?
NTM infection is often misdiagnosed. Delayed diagnosis often makes treatment more difficult because of possible drug resistance and increased lung or tissue damage due to recurrent infections. Prior use of a single drug may have created drug resistance, which means that timely diagnosis and proper treatment is essential.
The diagnosis of NTM involves the following:
I. Sputum smear and culture – Acid fast bacilli (AFB) smear and culture are the basic tests to identify mycobacteria. For accurate identification of the strain of NTM and drug sensitivities, testing should be done at a specialized laboratory.
If you have difficulty coughing up sputum (mucus or phlegm), your doctor may decide to have you inhale medicine to induce sputum or perform a bronchoscopy to obtain the necessary sample.
II. Chest CT – A CT (CAT) scan is a three-dimensional image generated from a large series of two-dimensional x-ray images.
A CT scan provides the doctor with a detailed look at the extent and location of disease and is an important diagnostic tool. NTM diagnosis and follow-up generally requires a high-resolution CT scan without contrast. X-rays alone are insufficient.
III. Medical History – Knowing illnesses you and your blood relatives have had, including childhood illnesses, provides your doctor with information to understand why certain underlying lung conditions exist. When dealing with extrapulmonary or disseminated disease, it’s important for your doctor to know of any recent incidents which may have caused skin punctures, including medical procedures or other surgeries. For more information on diagnostics and tips on gathering a family health history, visit ntminfo.org.
IV. Tissue or Fluid Biopsy – In the case of extrapulmonary or disseminated NTM infection, a biopsy of the tissue that is infected or a sample of the fluid in the area is collected and sent to a specialized lab for an AFB smear and culture. Because the causes of skin ulcers or lesions can often be misdiagnosed at first, identifying the pathogen in a timely manner is important.
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