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Volume 17, Number 3—March 2011


Mycobacterium lentiflavum in Drinking Water Supplies, Australia

Henry M. MarshallComments to Author , Robyn Carter, Matthew J. Torbey, Sharri Minion, Carla Tolson, Hanna E. Sidjabat, Flavia Huygens, Megan Hargreaves, and Rachel M. Thomson
Author affiliations: Author affiliations: The Prince Charles Hospital, Brisbane, Queensland, Australia (H.M. Marshall); The Royal Brisbane Hospital, Brisbane (R. Carter, M.J. Torbey, S. Minion, C. Tolson); University of Queensland Centre for Clinical Research, Brisbane (H.E. Sidjabat); Queensland University of Technology, Brisbane (F. Huygens, M. Hargreaves); Queensland Tuberculosis Control Centre, Brisbane (R.M. Thomson)

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Table 1

American Thoracic Society/Infectious Diseases Society of America diagnostic criteria for NTM lung disease*

Clinical criteria
Pulmonary symptoms AND
Nodular or cavitary opacities on chest radiograph OR
Multifocal bronchiectasis with multiple small nodules on
high-resolution computerized tomography AND
Appropriate exclusion of other diagnoses
Positive culture results from at least 2 separate expectorated
sputum samples OR
Positive culture results from at least 1 bronchial wash or
lavage OR
Biopsy† showing granulomatous inflammation or acid-fast
bacilli and positive culture OR
Biopsy† showing granulomatous inflammation or acid-fast
bacilli and one or more culture-positive sputum or bronchial
• Risk-benefit of therapy should be considered for each patient
•      before institution of therapy
• Expert consultation should be obtained when NTM are
• recovered that are either infrequently encountered or that
•      usually represent environmental contamination
• Patients suspected of having NTM lung disease but who do
• not meet the diagnostic criteria should be followed until the
•      diagnosis is firmly established or excluded

*Adapted from (2). NTM, nontuberculous mycobacteria.
†Transbronchial or other lung biopsy.

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