Persistently negative tuberculin reactions: their presence among children with culture positive for Mycobacterium tuberculosis (tuberculin-negative tuberculosis)
P. Steiner, M. Rao, M. S. Victoria, H. Jabbar and M. Steiner
Mantoux tests were performed on 200 children with culture-proven
Mycobacterium tuberculosis infections. A group of 28 patients initially had
negative reactions to 5 TU PPD-S. Of these, 17 had had extensive or
overwhelming tuberculous disease at the time of admission, seven of whom
reacted to 250 TU PPD; after a course of chemotherapy, all the survivors
had positive reactions to 5 TU PPD-S. The 11 with less severe disease had
negative reactions to 5 TU PPD-S and 250 TU PPD, as well as to PPD-A/B/G;
in only two could a ready explanation be found for the negative reactor
state. In general, a small number of children without life-threatening
forms of tuberculosis may have persistently negative tuberculin reactions
without any apparent cause. In such cases, other criteria for diagnosis
must be relied on, such as lymphocyte transformation, culture, and biopsy.
