What is the definition of disseminated NTM disease?
Disseminated NTM disease is defined as a case that meets one of the following criteria
- Cases in which NTM is detected in blood or bone marrow cultures
- Cases of NTM in sterile specimens from more than one organ
- Cases with a clinical diagnosis of disseminated NTM*
* The "3" category includes cases diagnosed as disseminated NTM even without bacteriological diagnosis, based on imaging findings and clinical course, such as marked response to antimicrobial chemotherapy.
Can a blood culture bottle for general bacteria (aerobic bottle + anaerobic bottle) be used when disseminated NTM is suspected?
From the point of view of sensitivity, it is recommended to use a blood culture bottle for mycobacteria. If not available, collect 10 mL in a sterile blood collection tube containing an anticoagulant (SPS or EDTA).
What tests should be performed to screen for the causative disease of disseminated NTM disease?
In cases of adult-onset disseminated NTM disease, if the patient is receiving chemotherapy, steroids, or immunosuppressants, or has underlying conditions such as hematologic malignancies or HIV infection, these factors may be considered as potential causes.
For other possible causes, please consider the following initial test findings for differential diagnosis:
- QFT (anti-IFNγ neutralizing antibodies)
- Monocyte count in a complete blood count (GATA2 deficiency)
- CD4 (Idiopathic CD4+ T-cell lymphocytopenia)