![]() Generally, immediate treatment initiation is recommended for FC cases or extensive disease due to the possibility of rapid lung destruction. In contrast, the nodular bronchiectatic (NB) type occurs predominantly in post-menopausal, nonsmoking females with frequent involvement in the right middle lobe or lingula and tends to have much slower progression than the FC type. ![]() If left untreated, it can progress within a relatively short time period, leading to extensive lung destruction and respiratory failure. The fibrocavitary (FC) type usually develops in middle-aged male smokers and accompanies apical fibrocavitary lesions. MAC organisms consist of two main species, i.e. M. avium and Mycobacterium intracellulare, and two radiological types of MAC-LD have been described. ![]() Of the NTM-related pulmonary diseases, Mycobacterium avium complex lung disease (MAC-LD) is the most common, with the incidence and prevalence increasing in many countries. Nontuberculous mycobacteria (NTM) are ubiquitous organisms in the environment. Of the untreated patients with stable MAC-LD, 51.6% underwent spontaneous sputum conversion, with younger age, higher body mass index and negative sputum acid-fast bacilli smear at initial diagnosis found to be predictors of this occurrence.Īdvanced age, fibrocavitary type and abnormal pulmonary function were negative prognostic factors for survival in patients with stable MAC-LD. Patients with stable MAC-LD were more likely to have higher body mass index and less systemic symptoms at initial diagnosis compared with patients with progressive MAC-LD, while positive sputum acid-fast bacilli smear, fibrocavitary type and more extensive disease in radiological findings were more associated with progressive MAC-LD. Of 488 patients diagnosed with MAC-LD between 19, 305 patients (62.5%) showed progressive MAC-LD resulting in treatment initiation within 3 years of diagnosis and 115 patients (23.6%) exhibited stable MAC-LD for at least 3 years with a median follow-up duration of 5.6 years. The aim of this study was to investigate the natural course of untreated stable MAC-LD, with a focus on factors associated with clinical deterioration, spontaneous sputum conversion and prognosis. Little is known about the long-term natural history of Mycobacterium avium complex lung disease (MAC-LD) in untreated patients with stable course.
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