What is mycobacterial lung disease?
Mycobacterial lung disease is an infection caused by a group of bacteria known as mycobacteria. Certain types of this bacteria can cause nontuberculous mycobacterial (NTM) lung disease, which is inhaled from soil, water, and dust. Other mycobacteria can cause tuberculosis (TB), which can be spread through droplets released when people with the disease speak or cough. In both lung disorders, a weakened immune system can put you at risk of infection.
It’s important to see a doctor who specializes in lung diseases and who can accurately diagnose and treat mycobacterial lung disease. Penn Medicine’s chronic lung disorders experts, including our specialists at the Mycobacterial Infection Clinic, use advanced diagnostic tests and prescribe treatments that can clear the infection from your lungs and help you make a full recovery.
Types of mycobacterial lung disease
NTM lung disease has two forms. Nodular bronchiectasis causes inflammation in your airways, which can lead to damage and scarring. This makes it hard for mucus to move out of your airways and can cause respiratory infections like bronchitis and pneumonia. The other form is cavitary disease, which causes scarring and cavities or pits in lung tissue. Over time, cavitary disease can lead to respiratory failure.
TB also has two types, depending on whether your body can fight off the infection. If you have active TB, the bacteria that cause the disease are growing in your body, you have symptoms, and you can spread the disease to other people. If you have inactive TB, you’ve been exposed to the bacteria, but you didn’t get sick and you can’t spread the disease.
Symptoms of mycobacterial lung disease
Your symptoms can vary based on the type of mycobacterial lung disease you have.
Although most people don’t get sick from NTM, people who have weakened immune systems are at risk of becoming infected. Symptoms may include:
- Shortness of breath and wheezing
- Chronic cough that brings up mucus or blood
- Fatigue
- Loss of appetite and weight loss
- Low-grade fever
- Night sweats
- Chest pain
- Repeated respiratory infections
An active TB infection affects the lungs and other parts of your body. Symptoms may include:
- Cough, including coughing up blood or mucus
- Chest pain and pain when breathing
- Fatigue
- Fever
- Chills
- Night sweats
- Weight loss
What causes mycobacterial lung disease?
A mycobacterial infection in the lungs is caused by inhaling bacteria.
NTM lung disease is caused by inhaling nontuberculous mycobacteria from soil and water. Because the bacteria are found around the world, everyone is exposed but most don’t get sick. You can develop NTM lung disease if you have a condition that makes it harder for you to fight off infections, such as these pulmonary disorders:
- Bronchiectasis
- Recurring pneumonia
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Pulmonary fibrosis
- Lung cancer
You might also develop NTM lung disease if you have a weakened immune system from other conditions, like rheumatoid arthritis, Sjogren’s syndrome, or an HIV infection. Taking chemotherapy or using inhaled corticosteroids can also make you susceptible to an NTM infection. Women after menopause and people older than 65 are affected more often than others.
Tuberculosis is caused by a bacterium called mycobacterium tuberculosis. You can become infected if you inhale the bacteria when you’re near someone who has the disease. The bacteria are carried in tiny droplets that are released in the air when the person speaks, laughs, coughs, or sneezes. Having a weakened immune system from an HIV infection, diabetes, and other diseases can put you at risk of a TB infection.
Diagnosing mycobacterial lung disease
Before you’re diagnosed, your doctor will rule out other causes of your symptoms and will confirm that you’re infected with mycobacteria by testing a sample of mucus that you cough up, known as a sputum culture. You may need to do this several times. Depending on the type of bacterial lung infection you’re being evaluated for, you might also need a blood and skin test. Other tests can look at your lungs and test their function.
Mycobacterial lung disease treatment
You might not need treatment for NTM lung disease if you have mild symptoms that aren’t getting worse. In this case, your doctor may recommend watchful waiting. If you have worsening symptoms or if you have the more serious cavitary form of NTM lung disease, you’ll be treated with a combination of antibiotics for several months and have regular sputum tests to check for continuing infection. Airway clearance techniques and avoiding smoke exposure or other lung irritants can help you recover. If antibiotics aren’t enough to cure the disease, you might need surgery. If you have tuberculosis, you’ll need to take medications for several months, even if you have inactive TB. Treating inactive TB helps protect you from getting sick.
Preventing mycobacterial infection in the lungs
Although you can’t avoid nontuberculous mycobacteria, there are things you can do to lower your risk of getting infected if you have a weakened immune system. Use a ventilation fan in your bathroom and kitchen and avoid inhaling steam from spas and hot tubs. When you’re working outside, wear a mask, try not to stir up dirt and dust, and wet potting soil to reduce dust in the air. Getting vaccinations like the flu shot can also help. To prevent tuberculosis, avoid close contact with people who have an active infection.
Expert care for a complex disease
Mycobacterial lung disease can be challenging to diagnose and treat, especially if you already have a lung disorder like COPD. As a leading provider of lung care in the southeastern Pennsylvania and New Jersey regions, Penn Pulmonology’s specialists have the expertise to rule out other causes of your symptoms and recommend the most effective treatments. We also have highly skilled lung surgeons if surgery is needed. With deep experience treating lung diseases, our specialists can put you on a path to recovery.
You benefit from a personalized treatment plan and the expertise of providers with a variety of expertise, including specialists in pulmonary diagnostic testing and pulmonary rehabilitation. We also provide education and offer support through counseling services. Our highly skilled lung surgeons can perform surgery, if needed. With deep experience treating lung diseases, our specialists can put you on a path to recovery.