American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
www.thoracic.org
CLIP AND COPY
What causes NTM lung disease?
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(types) of bacteria that are found naturally in the
environment. The existing species of NTM can
vary from place to place in the world. The most
common species causing lung disease is called
Mycobacterium avium complex group. The next
most common are Mycobacterium abscessus
complex and Mycobacterium kansasii. Everyone
inhales NTM into the lungs; however, only a very
small number of people develop NTM lung disease.
Who gets NTM lung disease?
Some people are at higher risk of getting an
NTM lung infection and developing lung disease.
People who have an existing lung disease such as
bronchiectasis (enlargement of airways), chronic
obstructive pulmonary disease (COPD), cystic

had prior lung infections such as tuberculosis are
at increased risk of NTM lung disease. Patients
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


disease as part of a disseminated NTM (widespread
in the body) infection.
What are the signs and symptoms of NTM lung
disease?
NTM causes symptoms similar to a chronic and
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include:
■
cough with sputum production,
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tiredness (fatigue),
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fever,
■
coughing up blood (hemoptysis)—a late sign of
illness,
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shortness of breath,
■
unplanned weight loss.
(For more information on pneumonia, see the ATS
Patient information series at www.thoracic.org/
patients)
How is NTM disease diagnosed?
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NTM bacteria and is not ill from it, (which we called
colonized) from those with true NTM lung disease.
Therefore, the diagnosis depends on:
(1) tests to show the presence of NTM bacteria
What is Nontuberculous
Mycobacteria (NTM) Lung Disease?
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Online version updated December 2021
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NTM are bacteria that are normally present in the environment.
Inhalation of these bacteria may cause disease in both healthy
patients and those with compromised immune systems.

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
does not happen, in contrast to transmission of tuberculosis
(Mycobacteria tuberculosis), which is common.
The number of people with NTM lung disease is increasing
worldwide. (For more information on tuberculosis, see
ATS Patient information series at www.thoracic.org/patients)
American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
www.thoracic.org
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symptoms and additional tests showing evidence
of active disease.
Sputum (mucus) is looked at under the microscope
to see if NTM bacteria are present. Cultures to try
to grow the bacteria are also done. Some NTM
grow rapidly in culture—within a few days—but
some NTM types take several weeks to be detected
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diagnosis of NTM lung disease. Bronchoscopy
is sometimes needed to obtain lung samples.
(See ATS Patient Information Series ‘Flexible
www.thoracic.org/patients.)
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sampling or tissue biopsy may be needed. Your
healthcare provider will order other tests including
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resolution CT scan.
Your healthcare provider will discuss which tests
are best for you and what the results show.
Repeat sputum cultures are typically done during
treatment to measure its success.
How is NTM disease treated?
Treatment and outcomes depend on which NTM
species is causing disease. A decision to treat NTM
disease is often based on symptoms, microbiological
culture data and other test results. Typically
NTM lung disease is treated with three or more
antibiotics until sputum cultures have been negative
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include macrolides, ethambutol, rifamycins,
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and linezolid. Treatment may be complicated by
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these antibiotics. Treatment is usually done by a lung
or infectious disease specialist who has experience
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close follow up during treatment. Other therapies
may also be used, such as airway clearance.
Author: Monica Campo, MD, MPH
Reviewers: Timothy Aksamit, MD; Kevin Fennelly, MD;
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
This information is a public service of the American Thoracic Society.
The content is for educational purposes only. It should not be used as a
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Resources:
American Lung Association


COPD Foundation
www.copdfoundation.org
Bronchiectasis and NTM Initiative
www.BronchiectasisandNTMInitiative.org
National Institutes of Health (Medline Plus)
https://medlineplus.gov/mycobacterialinfections.html
American Thoracic Society
https://www.thoracic.org/patients (patient materials)

 (clinician
materials)
CHEST Foundation
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NTM Info & Research, Inc.
ntminfo.org
R Action Plan
4 Seek medical attention if you have symptoms of
pneumonia such as cough, fever and fatigue that
do not resolve within two weeks.
4 Talk with your healthcare provider if your
respiratory symptoms do not get better as
expected with treatment for pneumonia or if you
cough up blood.
4 Take all medications and antibiotics as
prescribed.
4 Avoid use and exposure to tobacco products.
4 Get immunizations including

provider.
Healthcare Provider’s Contact Number: