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ELECTRONIC ARTICLE: Clyde Walter Worley, Kimberly Ann Worley, and P. Lucy Kumar Infectious Disease Challenges in Immigrants From Tropical Countries Pediatrics 2000; 106: e3 [Abstract] [Full text] [PDF]

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Is a PPD reactive test the same as Tuberculosis?

Rafael Nunez   (27 July 2000)

Is a PPD reactive test the same as Tuberculosis? 27 July 2000
Rafael Nunez, Assistant Professor Institute of Virology, University of Zurich Send letter to journal: Re: Is a PPD reactive test the same as Tuberculosis? rafaeln{at}vetvir.unizh.ch Rafael Nunez	Is a PPD reactive test the same as Tuberculosis? Dear Sir, the recent publication in Pediatrics of the case of a 16- year old African immigrant with dual diseases, deserve all the praise to the authors for reporting this case as well as to the editorial team of Pediatrics for putting the topic of health care in the immigrants from the third world countries into the main street of Pediatrics. The authors mentioned that there are not pathological findings in two chest radiograms. In addition, the case report does not disclosed if there is a clear record of contact with tuberculosis. Therefore, I have the impression that the diagnosis of tuberculosis was based only on the reactivity of the PPD. Moreover, the whole set of symptoms and signs of the patient could be explained only by the atypical case of malaria instead of two concurrent diseases. Recent reports (1-3), have provide more information regarding the value of the PPD and its potential use as tuberculosis screen test, including an intradermal test with antigenic fractions of the mycobacterium that discriminate between active and non-active disease (2). It is likely that the days when an immigrant from endemic areas for tuberculosis and reactive PPD receive a prophylactic treatment of six months with isoniazid are numbered because more accurate diagnostic test are being developed References 1: Hoft DF, Leonardi C, Milligan T, Nahass GT, Kemp B, Cook S, Tennant J, Carey M. Clinical reactogenicity of intradermal bacille Calmette-Guerin vaccination. Clin Infect Dis. 1999 Apr; 28(4):785-90. 2: Arend SM, Andersen P, van Meijgaarden KE, Skjot RL, Subronto YW, van Dissel JT, Ottenhoff TH. Detection of active tuberculosis infection by T cell responses to early-secreted antigenic target 6-kDa protein and culture filtrate protein 10. J Infect Dis. 2000 May;181(5):1850-4. 3: Villarino ME, Brennan MJ, Nolan CM, Catanzaro A, Lundergan LL, Bock NN, Jones CL, Wang YC, Burman WJ. Comparison testing of current (PPD-S1) and proposed (PPD-S2) reference tuberculin standards. Am J Respir Crit Care Med. 2000 Apr;161(4 Pt 1):1167-71. Dr. Rafael Nunez, MD. MSc. Assistant Professor Correspondence Dr. Rafael Nunez MD Institute of Virology University of Zurich, Winterthurerstrasse 266a, 8057 Zurich, Switzerland rafaeln@vetvir.unizh.ch