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Nontuberculous Mycobacteria (NTM)


Nontuberculous mycobacteria (NTM) is a group of bacteria, normally found in soil and water and some domestic and wild animals, that can cause severe lung disease. Although NTM naturally exists in the environment and doesn't affect most people, some develop an NTM infection when they inhale the bacteria in the air or water mist, or when they drink water containing NTM.

Each year in the United States, about two in every 100,000 people develop an NTM infection. Some people who are susceptible to the infection have an unknown defect in their lung structure or immune system, lung damage from a pre-existing chronic obstructive pulmonary disease (COPD), such as emphysema and bronchiectasis, or an immune deficiency disorder, such as HIV or AIDS.

NTM does not cause tuberculosis (TB), and unlike TB, which is spread from person to person, NTM is not contagious.

Our Approach to Nontuberculous Mycobacteria

NTM infections can cause symptoms seen in other lung conditions, making diagnosis a challenge. UCSF pulmonologists are experts at detecting and treating these infections, and tailor therapy to the species of bacteria causing each patient's illness. The medication regimens may have side effects, so our specialists monitor patients closely during treatment.

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  • Best in Northern California and No. 4 in the nation for pulmonology & lung surgery

Signs & symptoms

Although nontuberculous mycobacteria can affect all organs of the body, the condition primarily affects the lungs. Symptoms typically progress slowly and may include:

  • Blood in sputum (mucus and other matter brought up from the lungs, bronchi, and trachea)
  • Cough
  • Fever
  • Lack of appetite
  • Loss of energy
  • Night sweats
  • Weight loss


In making a diagnosis of nontuberculous mycobacteria, your doctor will first start by conducting a thorough physical examination, recording your medical history and asking about any symptoms you may be experiencing.

Diagnosing NTM may be difficult because symptoms often resemble those caused by other health conditions, such as tuberculosis (TB). If a patient does have NTM, it is important to determine which type of bacteria is causing the condition.

The following tests may be also be conducted to make a definite diagnosis:

  • High Resolution Computed Tomography (HRCT) This is a special type of CT scan that provides your doctor with high-resolution images of your lungs. Having a HRCT is no different than having a regular CT scan; they both are performed on an open-air table and take only a few minutes.
  • Sputum Culture Several samples of your sputum will be tested in a specialized lab to check for NTM bacteria.
  • Bronchoscopy This test involves passing a flexible fiberoptic scope, about the diameter of a pencil, into the lungs to obtain fluid and sometimes tissue samples to aid in diagnosis. This test is an outpatient procedure, which means you do not have to stay overnight in the hospital, and is performed by your doctor.


Treatment for nontuberculous mycobacteria will depend on the specific bacteria causing your infection. Treatment may be difficult because NTM bacteria may be resistant to many common types of antibiotics.

For some patients, the same drugs used to treat tuberculosis (TB) will be recommended.

To avoid becoming resistant to medications, you may take several types of antibiotics at the same time. These drugs may cause side effects and your doctor will monitor you closely during your treatment regimen. The length of treatment varies, depending on the severity of the disease.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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