Title : Bacterial infections
Abstract:
Aims: To highlight the challenges in diagnosing NTM-PD in tuberculosis endemic countries.
Objectives: 1) Document the clinical profile of patients who presented with tuberculosis-like symptoms but were later diagnosed with NTM-PD.
2) Review the diagnostic methods used to diagnose NTM-PD.
Material & Methods: Between June 2023 and February 2025, 04 cases of NTM-PD were diagnosed and their relevant clinical, diagnostic, and treatment details were recorded after taking informed consent. Lead which pointed to the diagnosis of NTM was sputum AFB positive with CBNAAT negative for M. tuberculosis. Sputum samples for culture for NTM were sent on 2 separate occasions to confirm the diagnosis.
Results: We report 04 cases of NTM-PD. No significant history of immunosuppression present in our patients, whereas history of pulmonary tuberculosis present in 3 out of 4 patients. All of our patients diagnosed with different species of NTM (M. kansasii, M.scrofulaceum, M. avium intracelluare, M. abscessus). All of the patients were initially diagnosed as pulmonary tuberculosis and received the conventional four drug regimen before being diagnosed as NTM-PD.
Conclusion: Most of the patients of NTM-PD are treated as pulmonary tuberculosis. The NTM-PD masquerading as pulmonary tuberculosis poses a dilemma for physicians, high suspicion for NTM infections must be considered in patients with chronic lung disease. The delay in diagnosis contribute to significant complications, morbidity and mortality. Through this case series we would like to emphasize the importance of considering NTM as differential diagnosis when pulmonary TB is suspected, particularly in patients who do not respond to standard TB therapy.
