Nontuberculous mycobacteria (NTM) infections are wounds or illnesses caused by Mycobacterium bacteria, except for those that cause tuberculosis and leprosy (Hansen’s disease). NTM can infect your lungs, skin, bones, lymph nodes or many organs in your body. M. avium complex (MAC) is the most common cause. NTM infections are treated with antibiotics.
Nontuberculous mycobacteria (NTM) infections are any illnesses caused by one of the bacteria in the genus (group) Mycobacterium. NTM don’t include Mycobacterium species that cause tuberculosis (M. tuberculosis complex) or leprosy/Hansen’s disease (M. leprae).
NTM are naturally found in dust, soil and water. NTM most commonly infect your lungs (NTM lung disease). But they can also infect your:
NTM infections can be localized (limited to one part of your body) or disseminated (spread to many parts of your body). But infections outside of your lungs are very rare in people who don’t have a compromised immune system.
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Symptoms common to many types of nontuberculous mycobacteria infection include:
You might have additional symptoms depending on where you’re infected. These include:
M. avium complex (MAC) is the most common cause of nontuberculous mycobacteria infections. Other examples of mycobacteria include:
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Mycobacteria are found in the environment — like soil and water. You can get an NTM infection from:
Because it can take a long time to experience symptoms after exposure to NTM, you might not know where or how you got the infection.
NTM infections are rarely contagious (they don’t spread from person to person).
Most people come in contact with NTM and don’t get sick. But you might be at higher risk for a nontuberculous mycobacterial infection if you:
People assigned female at birth (AFAB) with a low BMI and certain health conditions, like GERD (chronic acid reflux), scoliosis, pectus excavatum or mitral valve prolapse are at an increased risk for pulmonary NTM infections (Lady Windermere syndrome).
Complications of mycobacteria infections include:
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Healthcare providers diagnose NTM infections based on:
Depending on where in your body you have symptoms, you might need the following tests or procedures:
NTM infections share symptoms with many other illnesses. The only way to know if you have a nontuberculous mycobacteria infection is to see a healthcare provider and undergo testing looking specifically for NTM.
Healthcare providers often prescribe a combination of two to three types of antibiotics to treat mycobacteria infections. You may need to take these medications for up to 12 months to make sure the infection is completely gone. You might also need surgery to remove damaged tissue. Treatment for NTM lung infections includes breathing treatments and performing breathing exercises that help cough up bacteria and phlegm (sputum).
The specific antibiotics your provider prescribes depend on where your infection is and the species (type) of mycobacteria. You might be treated with a combination of:
Antibiotics can have a number of risks and side effects, especially with long-term use. Tell your provider if you experience side effects or notice any concerning symptoms. Depending on the treatment, you could experience:
If you have lung disease or a weakened immune system, you can reduce your risk of NTM infections by avoiding places where the bacteria might live. You might avoid:
The earlier an NTM infection is found, the easier it is to treat. If you have a mild NTM infection, you may not need treatment. But severe infections sometimes need ongoing treatment for years. Some NTM infections cause chronic (long-term) health problems such as persistent cough and breathing problems. Sometimes, even after successful treatment, the infection could come back (recur).
The outlook for NTM infections depends on the type of NTM causing it, where the infection is and any underlying health conditions. For instance, the five-year mortality (death) rate for NTM lung infections is between 13% and 45%.
If you have an implanted medical device, lung disease or a weakened immune system, or if you’ve had surgery, ask your healthcare provider what signs of infection you should look out for. Follow up with your provider if you have any concerning symptoms.
Go to the emergency room if you have any signs of severe illness, including:
If you have an NTM infection, you may want to ask your healthcare provider:
A note from Cleveland Clinic
Nontuberculous mycobacteria infections are rare. But if you have one, the diagnosis and treatment process can be long and require patience. Take all of your medications as prescribed and for as long as your healthcare provider recommends. Follow up with your provider frequently, especially if you have an underlying condition that affects your lungs or immune system. Let them know if you’re experiencing side effects from your treatment. They can help monitor your progress, adjust your medication if needed, and address any concerns along the way.
Last reviewed on 02/19/2024.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy