NTM: Symptoms

Like tuberculosis (TB), nontuberculous mycobacteria (NTM) infection often affects the lungs. Therefore, nontuberculous mycobacteria symptoms are similar.

Most NTM infections and resulting symptoms progress slowly. Some people may have had this infection for years before they are diagnosed. Symptoms may include:

• Fever
• Weight loss
• Cough
• Lack of appetite
• Night sweats
• Blood in the sputum (hemoptysis)
• Loss of energy
• Shortness of breath (dyspnea)

Rarely, people will have no symptoms, and the infection is discovered when chest imaging is ordered for other reasons. In these people, we would strongly recommend observation before launching into a complicated treatment regimen. The fever is often low grade.

Throughout history, tuberculosis was also described as “consumption.” The same phenomena can occur with NTM infection. Cough is a common complaint and can be either “dry” or “productive” of sputum. The color of the sputum is not helpful in the diagnosis. Blood in the sputum is unusual unless there is cavity formation (holes within the lung tissue) or severe bronchiectasis (dilation of the airways).

Night sweats may be mild or drenching.

Loss of energy is also described as fatigue, and this is a difficult symptom to quantify. Some people notice they don’t have the energy to do all the activities they used to do. Some people have to take naps to get through the day.

Shortness of breath may occur, but it is not universal. It may be related to an underlying lung disease, such as emphysema, which is exacerbated by the infection or simply by the infection itself.