STUDIES ON SPECIFIC TUBERCULIN REACTION - TUBERCULIN CONVERSION IN TUBERCULOSIS CONTACTS

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Abstract
Results have been presented of a study of the tuberculin reaction in tuberculosis contacts who have recently acquired a tuberculin skin sensitivity as indicated by conversion of the tuberculin reaction from negative to positive. This type of tuberculin skin sensitivity is considered most likely tobe a specific reaction to Mycobacterium tuberculosis, because it emerges in subjects heavily exposed to tuberculosis, and because it resembles closely the type of tuberculin reaction seen in tuberculous patients. The prevailing characteristics of the specific tuberculin reaction as seen in this study are the size of the reaction, measuring 15 mm. and more in diameter, and the predominance of the PPD-S reaction over reactions to the antigens PPD-Y, PPD-B, and PPD-A. When multiple PPD antigens are not available for differential skin testing, the size of a tuberculin reaction and its morphology may offer important practical clues in identifying a tuberculous infection. Not all tuberculin conversions are tuberculous in origin. Due consideration of this fact will increase the efficacy of contact investigation and better define the indication for chemoprophylaxis of the tuberculin converters. Infection by tubercle bacilli may cause cross-reactions to other mycobacterial antigens.

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