Anyone else diagnosed with MAC & Bronchiectasis without symptoms?

@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?

Thank you for all these details. My first appointment with the pulmonologist is on 5/13. Is Bronchiectasis also diagnosed from sputum? I thought that a high resolution lung scan would be another tool used for diagnosis, but maybe it's not necessary.

Bronchiectasis is disease process that changes the lungs, it is diagnosed from imaging, as the enlarged and inflexible bronchial tubes show on a CT.

MAC/NTM is an infection. Signs of it can be detected on an image, but it needs to be confirmed by a sputum culture.

I am glad you are seeing the doctor soon.

They might do a broncocospy to check out how advanced your BE is.

Just a note about the probable MAC diagnosis from CT…
I did have a horrid cough, but my bronchiectasis was caught because of follow-up CT done for another reason that had showed a couple nodules. Local and Mayo readiogists and pulmonologists thought I had MAC. Hard to produce cultures didn’t grow it, so I had bronch to get good sample. It was negative for MAC! I’d been very concerned, so great relief. I hope that is case for you.

The radiologists have continued to add that comment about MAC to explain the trees-in-bud and mucus impactions on CT and I asked my pulmonologist about it. He said radiologist love to add potential causes.
I have mild bronchiectasis and do airway clearance and no longer have the coughs. Good luck!.

So good to hear that CT Scans may not tell the whole story. I am eager to find out more and appreciate you sharing your experience. Great that you no longer have coughing!

Thanks. I am grateful to see the pulmonologist soon.

I had no symptoms, it was found when I had a PET scan

I had no symptoms other than that I randomly coughed to clear my throat and I coughed up blood. That prompted me to get an x-ray and the whole diagnostic process began. I had hiked 7 miles the day before with no problem. When they did a scan, they said I had pneumonia, which was crazy because I had absolutely no symptoms. I had had pneumonia 10 months prior, and 10 years prior, but nothing else. I am grateful to have caught it early so I can do everything I can to prevent it from getting worse.

Coughing up blood is scary. My husband clears his throat constantly; I think he needs to be evaluated. Glad you caught this early. Do you have MAC?