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NTM Symptoms, Causes & Risk Factors

The symptoms caused by NTM infection can vary from no symptoms to severe cough, fatigue, and weight loss. NTM disease is more common in individuals with underlying lung disease or weak immune systems.

What Are the Symptoms of NTM Lung Infections

Not everyone with NTM pulmonary disease has symptoms, but most have a combination of lung and other symptoms. The more severe the infection, the more likely you will have symptoms.

Symptoms of NTM lung disease can be classified into two categories: symptoms that mainly affect the lungs and symptoms that affect the whole body.

The most common respiratory symptoms of NTM lung disease are:

  • Cough that won't go away
  • Coughing up blood (hemoptysis)
  • Shortness of breath when active

Other symptoms of NTM lung disease include:

  • Fatigue
  • Low-grade fever
  • Night sweats
  • Weight loss

What Causes NTM Lung Infections?

NTM lung infections are caused by mycobacteria that are found in the soil and water. Most people who are exposed to environmental NTM do not become sick. Doctors do not know why only some people develop NTM lung disease. In most cases, people who get sick from NTM have some other health condition like another lung disease or a weak immune system.

What Are Risk Factors?

  • Age: NTM lung disease is more common in older people.
  • Lung disease: Many people with NTM lung disease have another underlying lung problem like COPD, bronchiectasis, or lung damage due to previous infections such as tuberculosis.
  • Slender Caucasian women: Some women appear to have an increased risk of developing NTM disease. These women share physical features like being tall and slender, having a curved spine, abnormalities of the breastbone, and mitral valve prolapse.
  • Weak immune system: Illnesses that affect the immune system, like Sjogren’s disease and rheumatoid arthritis, may increase the risk of NTM infection. Also, certain drugs that can weaken the immune system, such as prednisone and other steroids, can increase the risk of NTM infection.
  • Esophageal disorders: Acid reflux (GERD) and other disorders of the esophagus can increase the risk of NTM lung disease due to spillage of gastric contents into the lung.
  • Environment: Exposure to NTM in our environment can result in infection. High-risk sources include indoor hot tubs and pools and exposure to soil.

When to See Your Doctor

If you have a persistent cough, particularly if you also have fatigue, night sweats, shortness of breath or weight loss, you should see your doctor immediately. If your primary care provider cannot help your chronic cough, you might need to see a lung specialist.

    This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.


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