@crepass Hello –
Sorry I missed this post. Do you have any more information on your infection from your pulmonologist? There are varying ways to get a sputum sample. When first diagnosed, I was coughing 24/7 and they just used what I coughed up in the AM for 3 days in a row, delivered to their lab. Later when I had trouble coughing up sufficient sputum for a culture, my doc had me neb with 10% saline in the office – I coughed like crazy & they got enough to sample. My daughter's doc was doing a bronchoscopy on her for another reason, and got a sample during the test (hers was negative, thankfully.)
Maybe the pulmonologist meant that there is some evidence of MAC infection on the CT, but not a lot – as MAC progresses, if not treated, some people begin to show more evidence of infection – pockets or shadows, I've had docs describe them various ways.
The sputum sample, cultured for 6-8 weeks, tells the doc exactly what strain(s) you have. The "bugs" are then subjected to sensitivity testing to see which antibiotics they respond to. This is very important, because various strains respond to different antibiotics. I have M. avium intracellulare and M. gordonae, both of which respond to a combination known as the "Big 3" here – azithromycin, rifampin and ethambutol. I was treated for 18 months until my symptoms and the evidence of infection on the CT resolved. My sputum still tests positive, so I use 7% saline & a bronchdilator to try to keep it down. If I get symptoms again, I may need to restart those antibiotics or different ones (praying not!) Other people with different strains may be treated with other drugs, but almost all must be treated with more than one antibiotic, either in combination or alternating, because NTM (non-tubercular mycobacteria) are notorious for developing drug resistance.
If you have done much reading, here or elsewhere, you are aware that MAC is very slow-growing, needs to be treated for a long time to eradicate it, and occurs just about everywhere in the environment, so reinfection happens if you have bronchiectasis or other risk factors.
One thing you can assure your dentist is that MAC is not contagious to him, his staff, or his other patients.
Good luck with your treatment. Keep us informed & feel free to ask questions.