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Non-tuberculous mycobacterial pulmonary disease — SCE Respiratory MCQ

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HardRespiratory InfectionsNon-tuberculous mycobacterial pulmonary diseaseSCE Respiratory

A 64-year-old woman with bronchiectasis has chronic cough, weight loss and nodular-bronchiectatic changes in the right middle lobe and lingula. Three sputum cultures over 6 months grow Mycobacterium avium complex and she is smear negative. What is the most appropriate management?

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Correct answer: C — Specialist NTM assessment before multidrug macrolide-based therapy

Repeated positive cultures plus compatible symptoms and CT changes suggest NTM pulmonary disease, requiring specialist assessment and usually multidrug macrolide-based therapy if treatment criteria are met. Macrolide monotherapy risks resistance. Standard TB therapy is not the appropriate regimen for MAC disease.

Reference: BTS Guideline for NTM Pulmonary Disease; BTS Bronchiectasis Guideline