Table 1—

Criteria for diagnosis ofMycobacterium avium complex lung disease

Clinical criteria1) Compatible signs and symptoms (coughing, fatigue more common; weight loss, haemoptysis and shortness of breath may be present, particularly in advanced disease) with documented deterioration of the patient's clinical state if a base condition is present, and
2) Reasonable exclusion of other disease (e.g. tuberculosis, cancer, histoplasmosis) to explain condition or adequate treatment of other condition with increasing signs/symptoms
Radiographic criteria1) Any of the following chest radiographic abnormalities; if baseline films are >1 yr old, should be evidence of progression:
 Infiltrates with or without nodules (persistent for >2 months or progressive)
 Cavitation
 Nodules alone (multiple)
2) Any of the following high-resolution computed tomography abnormalities:
 Multiple small nodules
 Multifocal bronchiectasis with or without small lung nodules
Bacteriological criteria1) At least three available sputum/bronchial wash samples within 1 yr, as follows:
 Three positive cultures with negative AFB smears, or
 Two positive cultures and one positive AFB smear; or
2) A single available bronchial wash and inability to obtain sputum samples, as follows:
 Positive culture with 2+, 3+ or 4+ growth, or
 Positive culture with a 2+, 3+ or 4+ AFB smear; or
3) Tissue biopsy, as follows:
 Any growth bronchoplumonary tissue biopsy
 Granuloma and/or AFB on lung biopsy with one or more positive cultures from sputum/bronchial wash
 Any growth from usually sterile extrapulmonary site
  • For a diagnosis of pulmonary disease, all three criteria (clinical, radiographic and bacteriological) must be satisfied. AFB: acid-fast bacilli.