Consultant Respiratory Physician in London
NTM pulmonary disease specialist in London
Specialist assessment, second opinions and personalised ongoing care for people with suspected or confirmed non-tuberculous mycobacterial pulmonary disease.
- Consultant respiratory physician
- Experience managing complex lung infections
- Private appointments in London
Specialist NTM assessment
When should you see an NTM pulmonary disease specialist?
An appointment may be helpful if you have repeatedly positive NTM cultures, a suspected diagnosis or questions about monitoring, treatment or adverse effects. NTM pulmonary disease can be difficult to distinguish from NTM that is present in a sputum sample without causing active lung disease. A specialist review brings your symptoms, CT appearances and microbiology results together so that the meaning of a positive result—and the next step—is clearer.
Repeated positive cultures
You have grown the same NTM species from more than one sputum sample, or have received a positive bronchoscopic sample, and need to understand whether this represents disease.
Suspected or confirmed NTM-PD
Your symptoms, scan or laboratory results have raised concern about NTM pulmonary disease, or you already have a diagnosis and would like specialist care.
CT and microbiology interpretation
You need your scan pattern, NTM species, number of positive samples and susceptibility results considered as one clinical picture.
A treatment second opinion
You want an independent review of whether careful observation or antibiotic treatment is appropriate, including what would trigger a change in the plan.
Treatment monitoring
You are taking several antibiotics and need coordinated monitoring, interpretation of sputum results, or help managing possible adverse effects and medicine interactions.
NTM with bronchiectasis
You need the infection and the underlying airway condition managed together, including airway clearance, other infections and prevention of further lung damage.
A positive sputum result does not always mean treatment is needed
Diagnosis and treatment are separate decisions. The NTM species, symptoms, CT findings, repeated cultures, evidence of progression, general health and treatment burden all matter.
Specialist respiratory care
Why see Dr Ricardo José for NTM pulmonary disease?
Dr Ricardo José is a consultant respiratory physician who manages bronchiectasis, complex respiratory infections and pulmonary NTM disease. He provides private assessment for new diagnoses, complex results, second opinions and ongoing care.
Dr Ricardo José
MBChB · PhD · DA · FHEA · FRCP
Consultant Respiratory Physician
GMC registration: 6131510
A connected view of your lung health
NTM rarely sits in isolation. Dr José considers the organism alongside bronchiectasis, airway clearance, immune function, previous infections, nutrition, reflux or aspiration risk and your wider health.
Learn more about Dr Ricardo José- Specialist clinical interpretation Symptoms, CT imaging and microbiology are reviewed together—not as isolated test results.
- Experience with bronchiectasis and infection Care can address NTM and the structural airway disease that commonly accompanies it.
- Shared treatment decisions The potential benefit of treatment is weighed against its duration, monitoring requirements and effect on daily life.
- Ongoing specialist follow-up Reviews can monitor symptoms, cultures, imaging, lung function and medication tolerance over time.
- Multidisciplinary working Complex care may involve microbiology, radiology, respiratory physiotherapy, pharmacy and other specialists as appropriate.
- Clear explanations You receive a practical plan and an opportunity to discuss the questions that matter to you.
Reaching the right diagnosis
How Dr Ricardo José investigates NTM pulmonary disease
Investigation is personalised. Its purpose is to establish whether NTM is causing pulmonary disease, identify the organism accurately, assess severity and look for factors that may influence management.
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Review your symptoms and clinical history
Dr José asks about cough, sputum, breathlessness, fatigue, weight change, fever, night sweats, previous chest infections and how symptoms affect your daily life. Previous diagnoses, medicines and antibiotic courses are also reviewed.
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Interpret your CT scan and other imaging
CT images are assessed for changes that may support NTM pulmonary disease, such as bronchiectasis with small nodules, tree-in-bud change, mucus plugging or cavities. Earlier scans can help show whether abnormalities are stable or progressing.
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Review sputum cultures and species identification
Results are checked for the exact species or subspecies, the number and timing of positive samples, smear results and relevant drug susceptibility testing. Further sputum samples may be requested if the evidence is incomplete.
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Arrange targeted tests where appropriate
This may include lung-function testing, blood tests, immune assessment or bronchoscopy when adequate sputum samples cannot be obtained and diagnostic uncertainty remains. Tests are selected according to your individual circumstances.
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Assess associated bronchiectasis and wider risk factors
Airway damage, mucus clearance, reflux or aspiration, nutrition, immune function and other infections can influence NTM disease and are considered when relevant.
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Explain whether diagnostic criteria are met
Dr José brings the clinical, radiological and microbiological evidence together. You receive a clear explanation of whether results support NTM pulmonary disease and what the recommended next step is.
Useful records for your appointment
- CT images and radiology reports, including earlier scans
- All sputum, bronchoscopy and susceptibility results
- Recent lung-function and blood-test results
- A current medicine list and known allergies
- A summary of previous antibiotics and any adverse effects
Do not delay booking if you do not yet have everything. The practice can advise which records would be most useful.
Personalised management
How Dr Ricardo José treats NTM pulmonary disease
Treatment is not automatic after a positive culture. Dr José helps decide whether structured observation or antibiotic treatment is the most appropriate approach. Read more about when NTM pulmonary disease should be treated . He then builds monitoring and supportive care around that decision.
Decide whether to monitor or treat
The decision considers symptoms, species, CT pattern, cavitation, smear status, repeated cultures, progression, other health conditions and your preferences.
Select species-specific treatment
When treatment is appropriate, the antibiotic combination and schedule are selected for the NTM species, susceptibility results, disease severity and medicines you already take.
Support your lungs as a whole
Airway clearance, bronchiectasis care, nutrition, physical activity and management of co-existing conditions can remain important whether or not antibiotics are started.
Monitor response and safety
Symptoms, sputum cultures, blood tests, imaging and medicine tolerance are reviewed. Hearing, vision or heart-rhythm monitoring may be arranged for particular medicines.
Structured observation when treatment is not started
Some people meet diagnostic criteria but have mild or stable disease for which immediate antibiotic treatment may not offer the best balance of benefit and burden.
Observation is an active plan, not “doing nothing”. It can include planned symptom reviews, sputum cultures, weight and lung-function checks, airway-clearance support and repeat CT imaging when clinically appropriate. Dr José will explain which changes should prompt an earlier review.
Starting a multi-drug antibiotic regimen
NTM pulmonary disease usually requires more than one antibiotic. The regimen differs between organisms such as Mycobacterium avium complex, Mycobacterium kansasii, Mycobacterium xenopi and Mycobacterium abscessus.
Before treatment, Dr José reviews susceptibility results where relevant, other medicines, allergies, previous intolerance, kidney and liver function and the practical effect of treatment on your life. Complex cases may benefit from multidisciplinary discussion. If cultures remain positive despite appropriate treatment, a detailed review can help identify the next steps in managing refractory MAC pulmonary disease .
Managing adverse effects and medicine interactions
NTM antibiotics can cause adverse effects and can interact with other medicines. Potential problems vary by regimen but may affect the stomach and bowel, liver, kidneys, hearing, balance, vision, blood counts or heart rhythm.
Monitoring is planned around your medicines and individual risk. Dr José reviews possible symptoms early, coordinates appropriate tests and adjusts the plan where needed rather than expecting you to manage problems alone.
Airway clearance and bronchiectasis care
Many people with NTM pulmonary disease also have bronchiectasis. Retained mucus can contribute to cough and repeated infection, so an effective airway-clearance routine may be central to care.
Dr José can assess whether respiratory physiotherapy, changes to airway-clearance technique, inhaled or nebulised treatments and management of other airway infections should form part of your plan.
Monitoring response and completing treatment
Follow-up commonly considers symptoms, weight, sputum culture results, treatment adherence, adverse effects, blood results, lung function and imaging. The schedule depends on the organism, regimen and severity of disease.
Treatment can be prolonged. Culture conversion—the point from which sputum cultures remain negative—helps guide treatment duration, but decisions are always individual and should be made with the clinician supervising your care.
Your appointment
What happens at an NTM consultation?
Your consultation is focused on turning complex results into a clear, personalised plan. You will have time to explain your symptoms, concerns and treatment priorities.
Understand your story
Review symptoms, infection history, previous treatment, wider health and the effect NTM is having on everyday life.
Review the evidence
Consider CT imaging, sputum or bronchoscopy cultures, NTM species, susceptibility results and lung-function tests together.
Agree the next step
Decide whether more investigation, structured observation, antibiotic treatment or optimisation of bronchiectasis care is appropriate.
Plan follow-up
Set out the monitoring needed, how progress will be assessed and when symptoms or adverse effects should prompt contact.
Private NTM appointment
Get clarity about your diagnosis and treatment options
Book a consultation with Dr Ricardo José for specialist review of suspected or confirmed NTM pulmonary disease.
Frequently asked questions
Questions about NTM pulmonary disease
General answers to common questions. Your own diagnosis and treatment should always be discussed with the clinician responsible for your care.
Does one positive NTM sputum culture mean I have NTM pulmonary disease?
Not necessarily. NTM pulmonary disease is usually diagnosed by considering symptoms, compatible imaging and microbiological evidence together. The organism and sample type also matter. A specialist can explain how your result fits the diagnostic criteria.
If I meet the diagnostic criteria, must I start antibiotics?
No. Meeting diagnostic criteria and deciding to start treatment are separate steps. Some people benefit from treatment, while selected people may be monitored closely. The decision depends on the species, disease severity, progression, symptoms, treatment risks and personal priorities.
Is NTM pulmonary disease contagious?
NTM is generally acquired from organisms found in the environment and is not usually spread through ordinary social contact in the way that active pulmonary tuberculosis can be. Read more about where NTM comes from and environmental exposure . Particular infection-control advice may apply in some specialist settings, including for people with cystic fibrosis.
Can Dr José review a diagnosis or treatment plan made elsewhere?
Yes. A second-opinion consultation can review the available CT scans, microbiology, susceptibility results, treatment history and current symptoms. Recommendations depend on having enough clinical information and may include obtaining further tests.
Can Dr José help if I am having adverse effects from NTM medicines?
Dr José can review possible adverse effects, monitoring results and medicine interactions as part of your treatment plan. Do not stop or alter prescribed antibiotics without advice from the team responsible for your treatment. Seek urgent help for a severe or rapidly worsening reaction.
What if I have both bronchiectasis and NTM?
The conditions often need to be managed together. This may include airway-clearance physiotherapy, sputum monitoring and treatment of other infections alongside decisions about NTM antibiotics. Read about specialist bronchiectasis care .
Appointments and locations
How can I see Dr Ricardo José?
Private NTM pulmonary disease consultations are available at three central London locations. Remote video consultations may also be suitable for second opinions, review of results and follow-up when a physical examination is not required.
Chelsea · South Kensington
Royal Brompton Hospital
Private Outpatients, Old Fire Station, South Parade, London SW3 6LP.
Royal Brompton clinic informationMarylebone · Harley Street
77 Wimpole Street
77–79 Wimpole Street, Marylebone, London W1G 9RU.
Wimpole Street clinic informationMarylebone · Devonshire Place
The London Clinic
5 Devonshire Place, Marylebone, London W1G 6HL.
The London Clinic informationChoose the appointment route that suits you
The appointments team can help with clinic availability, video consultations, insurance and self-pay questions.
When to seek urgent medical help
Do not wait for a routine appointment
Call 999 or attend an emergency department for severe or rapidly worsening breathlessness, blue or grey lips, confusion, fainting, severe chest pain or coughing up a significant amount of blood. For other rapidly worsening symptoms, contact your GP, NHS 111 or the clinical team currently responsible for your care.
Appointments in London
Speak to Dr Ricardo José about NTM pulmonary disease
Arrange specialist assessment, a second opinion or ongoing review of suspected or confirmed NTM pulmonary disease.
