Diagnosis and treatment of nontuberculous mycobacterial lung disease: Clinicians' perspectives

Yon Ju Ryu, Won Jung Koh, Charles L. Daley

Research output: Contribution to journalReview articlepeer-review

129 Scopus citations

Abstract

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

Original languageEnglish
Pages (from-to)74-84
Number of pages11
JournalTuberculosis and Respiratory Diseases
Volume79
Issue number2
DOIs
StatePublished - Apr 2016

Keywords

  • Mycobacterium
  • Mycobacterium avium complex
  • Mycobacterium kansasii
  • Nontuberculous mycobacteria

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