Chest
The Loss of Tuberculin Sensitivity in Certain Patients with Active Pulmonary Tuberculosis
Section snippets
Material and Methods
Dilutions made from a 2 liter batch of Old Tuberculin obtained in 1939† have been used during the past 30 years for all routine tuberculin tests at Maybury Sanatorium. Available data4 indicate that the potency of the tuberculin has remained constant. Newly admitted patients at Maybury were given a Mantoux test using 0.1 ml of dilutions of 1:10,000, 1:1,000, 1:100 and 1:10 O.T. serially at 48-hour intervals until
Results
In tabulating the results each patient was assigned to one of five different sensitivity levels, or groups, depending upon the dilution of tuberculin to which he reacted. The final “O” group was reserved for those who failed to react to 1:10 O.T. The proportion of patients found in the various sensitivity groups has been published elsewhere ‡ .4 In the present series bacteriologic evidence of tuberculous infection was found in 55 of
Characteristic Findings in Tuberculin-Nonreactive Patients
Aside from the primary characteristic of failing to react to 10 mg of OT, the nonreactive tuberculous patients have the following findings in common:
- 1.
Smears of the sputum show great numbers of acid-fast bacilli* which, on culture, are found to be M. tuberculosis.
- 2.
The chest roentgenogram shows cavitation and gives evidence of
Discussion
The term tuberculin-nonreactive is a broad characterization which applies equally to the individual who fails to react to tuberculin because he has never been exposed to the tubercle bacillus, and to the 12 patients listed in Tables 1 and 2. In this respect tuberculin anergy is a more specific term since it implies abnormal hyposensitivity to tuberculin. The 1 mg dose of OT (0.1 ml of the 1:100 dilution) is comparable in potency to the second strength dose (0.005 mg) of PPD9; the patients in
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Active tuberculosis undiagnosed until autopsy
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1979, Journal of the American Academy of DermatologyClinical and roentgenographic spectrum of pulmonary tuberculosis in the adult
1977, The American Journal of MedicineThe effect of aging and acute illness on delayed hypersensitivity
1975, The Journal of Allergy and Clinical Immunology