@hurdgal Welcome to Mayo Connect - there are a number of members whose diagnoses were "incidental" - it does happen fairly often with calcium or heart scans.

The radiologist can see "artifacts" consistent with an NTM/MAC infection, and can also see Bronchiectasis, but to actually diagnose an infection, you will need to have a sputum culture done. This is where a sample of sputum from your lungs is grown is a lab for as long as 8 weeks, to see if you have an infection, then to determine exactly what it is and which antibiotics it is susceptible to. The sputum can be obtained by inducing you to cough it up (usually using a saline neb) or, if you cannot produce one, by a bronchoscopy.

If infection is found, the next step is to determine how to treat it. If it is mild and asymptomatic, you may be prescribed "wait and watch" approach, where you do airway clearance daily to get the mucus out, and get retested every 3 or so to see if the infection will go away without antibiotics.

If the infection is more severe, demonstrated by symptoms like fatigue, cough, fever & weight loss, the amount of infection, and whether there are cavities in your lungs, you would start on a course of antibiotic therapy, using 3 or more drugs, taken either three times a week or daily, over a period of 18 months or longer.

Typically Bronchiectasis, which is a chronic condition, is managed by a pulmonologist - but you need to find one familiar with this fairly rare condition. The infection may be treated by the pulmonologist, or you may see and Infectious Disease doc, but they are not familiar with the day-to-day life with Bronchiectasis, so in that case you would need both.

When is your next appointment?