Do you favor timely bronchoscopy for diagnostics over close surveillance in mildly symptomatic patients with CT findings suspicious for NTM infection who are not able to expectorate?

Yes, I do favor FOB to obtain BAL in symptomatic patients with suspected NTM.

Good comments. I think you would also need to clarify what "mildly symptomatic" means. If they have a dry cough, is that sufficient to label them? Imaging would have to be, correspondingly, a nodular/bronchiectacic pattern to fall into the mild category, not cavitary.

In that case, initiation of air...

It depends on what is meant by "mildly symptomatic." While bronchoscopy with lavage is considered low risk, I have personally seen significant complications arise in this patient population (spreading of infection/inflammatory response, hypoxia, and new areas of cavitation).

If a patient is deemed ...

I agree with Dr. @Dr. First Last. If the patient otherwise meets criteria for treatment (CT scan consistent with disease and symptoms of infection) then the most definitive way to determine if the patient has NTM disease is bronchoscopy/BAL.

However, for patients who are ambivalent about treatment o...