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Nontuberculous mycobacterial pulmonary infections in children

Andrea T Cruz, MD, MPH
Section Editor
Sheldon L Kaplan, MD
Deputy Editor
Mary M Torchia, MD


Nontuberculous mycobacteria (NTM) are a miscellaneous collection of acid-fast bacteria that are widespread in the environment [1]. They have been isolated from numerous environmental sources including water, soil, food products, and domestic and wild animals [2]. Health care-associated transmission has occurred with medical equipment [3-5].

More than 130 species of have been identified, not all of which have been documented to cause disease in humans [6-9]. NTM pathogens are classified as rapidly growing or slowly growing (table 1). Rapidly growing species grow within seven days and include Mycobacterium fortuitum, Mycobacterium abscessus, and Mycobacterium chelonae. Slowly growing species require several weeks to grow and include Mycobacterium avium complex (MAC), Mycobacterium marinum, and Mycobacterium kansasii. (See "Microbiology of nontuberculous mycobacteria", section on 'Classification'.)

NTM can cause a broad range of infections that vary depending on the particular NTM species and the host. In children, NTM cause four main clinical syndromes: lymphadenopathy, skin and soft tissue infection (SSTI), pulmonary disease (predominantly in children with underlying pulmonary conditions), and disseminated disease (predominantly in immune-compromised children).

This topic will provide an overview of NTM pulmonary infections in children. NTM lymphadenitis, SSTI, disseminated infection, and bacteremia in children are discussed separately. (See "Nontuberculous mycobacterial lymphadenitis in children" and "Nontuberculous mycobacterial skin and soft tissue infections in children" and "Disseminated nontuberculous mycobacterial (NTM) infections and NTM bacteremia in children".)


The most common NTM species causing pulmonary disease in adults in the United States are M. avium complex (MAC, M. avium and Mycobacterium intracellulare), M. abscessus, and M. kansasii [10]. Few data are available for children. However, MAC and M. abscessus are the species most frequently isolated from children with cystic fibrosis [11-16]. In one series of 17 children with NTM pulmonary disease, MAC was more common in previously healthy children (n = 5) and M. abscessus or M. chelonae in children with cystic fibrosis (n = 8) [17].

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Literature review current through: Nov 2017. | This topic last updated: Oct 12, 2017.
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