Spectrum of pulmonary nontuberculous mycobacterial infection

To organize pulmonary nontuberculous mycobacterial (NTMB) infections into a classification system based on clinical and radiographic features.

Scientific literature was reviewed and organized into a framework of clinical-radiographic syndromes of NTMB infection.

NTMB infection was classified into five clinical-radiographic syndromes. The "classical" form radiographically mimics tuberculosis. It is seen predominantly in white male patients with underlying chronic obstructive lung disease. "Nonclassical" disease radiographically appears as nodular infiltrates and bronchiectasis in a sporadic distribution. It characteristically occurs in elderly women without underlying chronic illness. Asymptomatic nodules are another manifestation. Immunocompromised individuals develop disseminated infection, often with few or no pulmonary symptoms but various chest radiographic manifestations. Patients with achalasia have a radiographic appearance that most often resembles aspiration pneumonia.

Most pulmonary NTMB infections can be classified into one of five categories, which helps in the understanding of these wide-ranging manifestations.