Sputum Culture- What does AFB Smear Positive mean?

Where I go for my BE/NTM care, a smear and culture are done at the hospital lab concurrently. If bacteria grows on the plate (smear-positive) and can be seen under a microscope, it indicates a high load. The sample that is added to a broth is grown for up to 8 weeks as most mycobacteria are slow-growing.

Hi, when we get our test results for MAC/NTM it comes in 2 parts. First is the AFB (acid fast bacillus) "fast" test of the sputum. Positive means mycobacterium detected during a short incubation.
Then the specimen is sent for a longer term growing out of the bacteria in a culture medium. This can take up to two months, and is usually only done if the AFB is positive, or if you have a history of NTM infections. The long culture allows the doctor to see exactly which HTM you have, and may be followed by sensitivity testing, to see which drug(s) may kill you specific infection.
It is not unusual to have different results from consecutive cultures, I think maybe @rits @poodledoc and @thumperguy have had this experience in the past.

@sueinmn I have mycobacterium abscesses in my sinuses. I had sinus surgery to correct chronic sinusitis. I did not have an AFB test prior to surgery. The doctor did one now because I'm 8 months post surgery and my sinuses are still infected. I'm also wheezing as this seems to be affecting my chest. I brought up this concern to my doctor and they ordered a chest CT with contrast. That came back normal. It seems as if the doctor has ruled out the infection in my lung just by the CT results. However, the more I read, I hear that a sputum test is needed to diagnose this in the lungs. Could I have this in my lungs but have a normal CT? Also, as I wait for doctors to determine the best treatment, I have also found out that my ferritin level has dropped to below the norm (36). Back tracking here, but I had ferritin infusions 4 years ago, as well as a uterine ablation to stop that bleeding and a colonoscopy to rule out internal bleeding. So I have not been losing blood over the past 4 years, and yet my ferritin is down to 36. Can this infection rob your body of stored iron? Could I have had this in my body for several years? I've been struggling with overall malaise, sinus pain, pain in joints, migraines, exhaustion, wheezing, etc, for many years now. Please provide any insight you may have.

@sueinmn I have mycobacterium abscesses in my sinuses. I had sinus surgery to correct chronic sinusitis. I did not have an AFB test prior to surgery. The doctor did one now because I'm 8 months post surgery and my sinuses are still infected. I'm also wheezing as this seems to be affecting my chest. I brought up this concern to my doctor and they ordered a chest CT with contrast. That came back normal. It seems as if the doctor has ruled out the infection in my lung just by the CT results. However, the more I read, I hear that a sputum test is needed to diagnose this in the lungs. Could I have this in my lungs but have a normal CT? Also, as I wait for doctors to determine the best treatment, I have also found out that my ferritin level has dropped to below the norm (36). Back tracking here, but I had ferritin infusions 4 years ago, as well as a uterine ablation to stop that bleeding and a colonoscopy to rule out internal bleeding. So I have not been losing blood over the past 4 years, and yet my ferritin is down to 36. Can this infection rob your body of stored iron? Could I have had this in my body for several years? I've been struggling with overall malaise, sinus pain, pain in joints, migraines, exhaustion, wheezing, etc, for many years now. Please provide any insight you may have.

@margiel17 I have the bacteria Pseudomonas in my system . For the past year and half I’ve had several different infections ….UTI, sinus infections , lung infections ,eye infections ..was treated at different times with IV antibiotics . I just brought up a sputum last month from the lungs which came back as Pseudomonas colonized . However asymptomatic so Drs choose not to treat . However they have referred me back to the Infectious Disease Dr to see if there is a way to treat and irradiate the Psuedomonas !
I’m scheduled for a CT Scan Monday so they can see my lungs from bringing up the sputum ! Then scheduled for a sinus CT scan …Will keep you posted with important information !

@kaybast praying you get good news to eradicate. I was told can never happen. I have bronchiactisis mac and psuedanoma aerigenosa. Just got over IV pics 14 days to push psuedanoma back. But i was told can never get rid of it. Just keep in asymptomatic then use IV again and or inhaledctobi etc . Im so sorry for you. Bless you

@margiel17 I don't have any insight on my own, but persistent or recurring infections in any part of the body really suggest that a referral to an infectious disease doc might be a good next step. Have you seen one?

@sueinmn I have mycobacterium abscesses in my sinuses. I had sinus surgery to correct chronic sinusitis. I did not have an AFB test prior to surgery. The doctor did one now because I'm 8 months post surgery and my sinuses are still infected. I'm also wheezing as this seems to be affecting my chest. I brought up this concern to my doctor and they ordered a chest CT with contrast. That came back normal. It seems as if the doctor has ruled out the infection in my lung just by the CT results. However, the more I read, I hear that a sputum test is needed to diagnose this in the lungs. Could I have this in my lungs but have a normal CT? Also, as I wait for doctors to determine the best treatment, I have also found out that my ferritin level has dropped to below the norm (36). Back tracking here, but I had ferritin infusions 4 years ago, as well as a uterine ablation to stop that bleeding and a colonoscopy to rule out internal bleeding. So I have not been losing blood over the past 4 years, and yet my ferritin is down to 36. Can this infection rob your body of stored iron? Could I have had this in my body for several years? I've been struggling with overall malaise, sinus pain, pain in joints, migraines, exhaustion, wheezing, etc, for many years now. Please provide any insight you may have.