Diagnosis and Treatment of Nontuberculous Mycobacterial Lung Disease / 대한내과학회지

ABSTRACT

The incidence of chronic pulmonary disease caused by nontuberculus mycobacteria (NTM) in human immunodeficiency virus (HIV)-negative patients has been increasing worldwide. In Korea, the common etiologic pathogens for this disease are Mycobacterium avium complex and Mycobacterium abscessus. Most NTM pulmonary diseases present one of two forms such as fibrocavitary or nodular bronchiectatic disease according to their radiographic features. However they also present hypersensitivity like diseases and solitary pulmonary nodules. NTM pulmonary disease has specific diagnostic criteria including repeated isolations of organisms because they are ubiquitous environmental organisms and NTM isolation can be a result of specimen contamination. However diagnosing NTM pulmonary disease does not mean the need for immediate treatment. Also since it needs multiple antibiotics for a long time, treatment is expensive and has significant side effects. Therefore treating NTM lung diseases can be extremely difficult and factors such as patient's age, comorbid conditions, and progression rates of symptoms and disease should be considered in the decision of treatment.