Bronchiectasis and nontuberculous mycobacterial infection (NTM) are two respiratory conditions that share similar symptoms, including cough, mucus production, shortness of breath, blood spitting, wheezing, fatigue, and even weight loss.
Because their symptoms may be similar, it’s not always easy to distinguish between the two — but bronchiectasis and NTM are not the same, and getting the right diagnosis is essential for the right treatment.
David Kamelhar, MD, Eric Teller, MD, and our team at Kamelhar-Teller Pulmonology can help. Dr. Kamelhar is a co-director of the Bronchiectasis and Nontuberculous Mycobacterium Program at NYU Langone Health, and he has decades of experience in advanced lung care.
If you’ve noticed worsening lung symptoms, read on to learn more about the differences between bronchiectasis and NTM.
Bronchiectasis is a chronic lung condition that develops when bronchial tubes become permanently wider and thicker. It may be the result of another lung condition that damages your bronchial tubes, such as a previous pneumonia or bronchitis, chronic obstructive pulmonary disease (COPD), or cystic fibrosis, a genetic disorder. It has been recently noted that there is a strong connection between esophageal disorders (GERD) and swallowing disorders as well. The damage makes the walls of the bronchial tubes weaker, the cilia (little hairs in the bronchial tubes that move mucus) do not work, and bacteria and mucus accumulate in the bronchial tubes. It becomes more likely for infection to occur and the bronchial tubes may become even weaker and the condition worse still.
NTM, on the other hand, is a type of bacterial infection that occurs in your bronchial tubes. It’s caused by a group of bacteria called nontuberculous mycobacteria (NTM), which are commonly found in soil and water. NTM infections are increasing significantly in the United States. Having bronchiectasis or another chronic lung condition can increase your risk of developing NTM infection. It is important to remember that everyone is exposed to NTM. You cannot catch NTM from another person.
Both bronchiectasis and NTM are often associated with other respiratory conditions like COPD or asthma. Both conditions can also be exacerbated by environmental factors like pollution, smoking, or exposure to certain chemicals or allergens.
The primary difference between bronchiectasis and NTM is the underlying cause. While bronchiectasis can be caused by a range of other health issues, NTM infections are specifically caused by the nontuberculous mycobacteria bacteria.
Another difference between the two conditions is the way we diagnose them. In most cases, we use imaging tests, specifically CT scans, to diagnose bronchiectasis. The CT may suggest NTM infection, but analysis of mucus or sputum is required to identify NTM. It is also important to note that there are numerous types of mycobacteria or NTM.
Most important in both bronchiectasis and NTM infection is to be certain that no underlying cause is present from the time these conditions are detected so that worsening of the disease can be prevented.
Treatment
In most cases, mycobacterial infection does not require treatment and can be kept in control by a combination of breathing exercises and correction of digestive or esophageal disorders. On the other hand, NTM can be more advanced and require a careful selection of antibiotics. That is why it is important to be certain of the specific type of mycobacteria that is present; some types are more difficult to treat and more likely to get worse than others.
Our approach
We take a comprehensive approach to improving your lung health. For bronchiectasis, we typically recommend breathing exercises, airway clearance devices, and in some cases medication, along with lifestyle changes such as regular exercise and a healthy diet.
For NTM infection, we determine the relative safety of watching rather than treating (watchful waiting). It is of the utmost importance to follow the status of the infection by CT scans and periodic cultures. However, NTM infections can be difficult to treat, so we monitor your condition closely and make adjustments to your treatment plan as needed to ensure the bacteria do not cause damage to your lungs
We carefully abide by the most recently published and state of the art Guidelines for NTM management in making these decisions.
We strongly encourage patients to participate in the management of these conditions and invite you to attend regularly scheduled courses and meetings hosted by the NYU Bronchiectasis and NTM Program. We also encourage patients to join the July 2023 World Bronchiectasis Conference to be hosted by NYU Langone.
If you’re experiencing chronic respiratory symptoms like frequent chest colds, coughing, wheezing, or shortness of breath, it is important to seek professional care. Schedule an appointment with Dr. Kamelhar and our team in Midtown East, New York, New York, to get a diagnosis and start the treatment that’s right for you.
Call us at 212-685-6611 or book online today.
