Q. How is typical TB different from Atypical TB?

A. Typical TB a is contagious form of TB spread by aerosolized particles containing the bacteria with human to human transmission. It is potentially fatal if not treated.

Atypical TB or NTM or MOTT , of which MAC (Mycobacterium avium-complex) is one type ( other types being M.Kansasii etc ) is not spread from human to human , but is present in the environment and affects and infects specific groups of persons. You do not have to be HIV positive to get infected with MAC, although in HIV it may progress faster. The other groups of individuals this infects include those with chronic lung disease such as Emphysema/COPD/ Sarcoidoisis and in some cases middle age women with apparently normal lungs.

Q. What are the symptoms of ATYPICAL TB/NTM ?

A. Atypical TB may be totally asymptomatic or produce a variety of symptoms depending upon the immune status of the person or an underlying condition. If present in persons with HIV infection, the symptoms may range from respiratory illness to swollen glands, diarrhea, weight loss and abdominal pain. Respiratory symptoms in both HIV and non HIV persons may include cough, fever, chills, night sweats, coughing up of blood. Symptoms of TB and NTM are indistinguishable

Q. Is Atypical TB or NTM/MOTT  treatable?

A. Yes, provided adequate multi-drug therapy is available, taken and adhered to by the patient. It is however more difficult to treat than regular or typical TB and the cure rates are between 40-70%. It can recur more frequently too.

Q. Do patients with Atypical TB /NTM need to be isolated or wear masks etc?

A. Atypical TB is not contagious and does not have human to human transmission. One does not have to isolate these patients or have them wear masks etc. However, your doctor may opt to do that till he /she is sure that the patient does not have typical TB since at times, both infections can coexist.

Q. If I am told I have Atypical TB,or NTM  what should I do?

A. You should discuss the need for treatment, treatment plan and options with your physicians. Academic centers have experts dealing with this problem who can work with your physicians and guide you. Once it is determined that you do require treatment, obtaining the medicines and taking them as required are the cornerstone of the treatment plan.

Q. Is the Chest X-ray in case of typical TB different from Atypical TB?

A. No. Although subtle differences may exist, and more so on CT scans, it is very difficult to distinguish typical TB from atypical TB/NTM  based on the X-ray alone [Atypical TB.NTM  x-ray 1 - Atypical TB/NTM  x-ray 2] . It is therefore very important to detect these infections by repeated sputum studies and that is why your doctor may ask for repeated tests.