Non-tuberculous Mycobacteria infection (extra-pulmonary)
Reportable by Providers and LaboratoriesAbout this Reportable Disease
Infectious agent: Mycobacterium bacteria, except for Mycobacterium tuberculosis, M. gordonae, or M. leprae. These are free-living organisms that are ubiquitous in the environment, particularly soil and water.
Description of illness: Symptoms of extra-pulmonary mycobacterial infection may include fever, fatigue, weight loss, night sweats, lymphadenopathy, surgical site infections, wound infections, cellulitis, granulomas, sepsis, failure to thrive, and osteomyelitis. Healthcare associated M. chimaera infections from contaminated heater-cooler units used in cardiac surgeries have been described; these are often associated with non-healing sternal wounds in addition to the vague symptoms described above.
Interactive Disease Data
Laboratory Reporting for this Disease
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
- Extrapulmonary nontuberculous mycobacteria (NTM) infections are caused by environmental mycobacteria (all Mycobacterium species except M. tuberculosis, M. gordonae, or M. leprae) and involve non-lung sites (e.g., skin/soft tissue, lymph nodes, bone/joint, surgical sites, disseminated disease).
- NTM are ubiquitous in soil and water. Extrapulmonary infections and outbreaks most often occur in healthcare settings when procedures expose patients to contaminated water or contaminated equipment/solutions; surveillance of extrapulmonary NTM can help identify healthcare-associated infections and outbreaks.
- Risk for NTM infection is higher in older people, immunocompromised, or those with conditions such as open wounds; presentations vary by site and can be indolent, so diagnosis requires clinical suspicion and appropriate specimen collection.
- Diagnosis is laboratory-based (species-level identification when possible), typically requiring culture and/or molecular testing from the involved site; treatment can be complex and prolonged, often requiring specialist involvement and susceptibility-guided multidrug therapy depending on species and syndrome.
- In Tennessee, Non-tuberculous Mycobacteria infection (extra-pulmonary) is a reportable condition; reporting supports rapid detection of potential healthcare-associated clusters and outbreak response.
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What It Is
Nontuberculous mycobacteria (NTM) are bacteria found naturally in soil, dust, and water. Extrapulmonary NTM infection means the infection occurs outside the lungs, such as in the skin, soft tissues, lymph nodes, bones, or joints.
Who Is at Higher Risk
Anyone can get an NTM infection, but risk is higher for people who are older, have weakened immune systems, or have open wounds or other conditions that increase susceptibility.
Signs and Symptoms
Symptoms depend on the body site involved. Extrapulmonary NTM can cause skin or wound infections, swollen lymph nodes, or bone/joint infections, and symptoms may develop gradually rather than suddenly.
How It Spreads
NTM are not usually spread person-to-person. Infections can occur when NTM from the environment enter the body through breaks in the skin or during certain medical procedures if water, equipment, or solutions become contaminated.
Diagnosis and Treatment
Healthcare providers diagnose NTM infection using tests on samples from the affected area. Treatment varies by the type of NTM and site of infection and can require specialist care and multiple antibiotics over time.
This Page Last Updated: March 25, 2026 at 8:53 PM