MAC diagnosis- lab finding vs clinical diagnosis

Key Steps in Clinical Diagnosis:
Medical History: The clinician talks with the patient to gather details about current complaints, timeline of symptoms, and past health issues.
Physical Examination: The doctor checks vital signs, listens to internal organs, and looks for physical signs of illness.
Clinical Reasoning: The doctor compares the collected information against medical knowledge to form a working diagnosis.

Laboratory diagnosis is the process of identifying a disease or medical condition by testing clinical samples like blood, urine, or tissue in a medical laboratory

This is very helpful and confirmed what the current pulmonologist told me. I had no symptoms and no signs of lung damage beyond bronchiectasis and yet was told I had MAC disease back in 2011, presumably based on 1 lab finding and nothing else.

@sayaboleh
Please note that usually clinical diagnosis and laboratory or other medical tests are used together to help give a complete picture for a possible diagnosis for an individual patient.

As a MAC patient and a clinician; when there is a doubt retest. I suggest a bronchoscopy because then the sample is not contaminated. Keep in mind results to take 6 to 8 weeks to process with a culture and sensitivity. Those are very important test because the initial smear may not give you a positive but the culture will grow it out and the sensitivity will tell the provider which antibiotics are appropriate for the given pathogen. Hope this helps.

@cwal
I agree and I should emphasize that I very clearly do not have MAC now so I am not really questioning that. I am merely questioning if I ever had MAC at any point . I don't believe I did even though my chart says otherwise. I just noticed a long discussion on a different thread about not getting treated after a MAC diagnosis but no clear distinction between clinical or lab finding. It seems reasonable that a lab finding alone is not enough to warrant treatment that may end up being much worse than the disease.

@michelercccb
Thank you for your helpful and informed post. I am 82 yo who was dx w Bronchiectasis w NTM in 2016. After dx, my husband and I flew to see Dr Daniels at UNC chapel Hill Bronchectasis/NTM center that I found on internet. My local pulmonologist suggested I get tx w antibiotics but Dr Daniels suggested airway clearance 2x day forever which has worked! But I had recent flare and my symptoms are spitting up blood wo a cough.
My specimen was contaminated so it seems
a bronchoscopy would be helpful at some point bc I was treated w Bactrim. My first pulmonologist dx me from w NTM from bronchoscopy specimen

Maybe Dr Daniel’s can re-evaluate you since you are now having bloody sputum. That seems to be a significant change. Bacterium is a great drug but he may need a different gun. I am sure he will offer you an opportunity to revisit your situation or put you in contact with someone who can manage your new situation. Prayers and healing for your health my friend.