A healthy patient with positive mantoux test but negative quantiferon Gold assay and no evidence of risk factors – to treat or not to treat? | Zendy

Lazara Karelia Montané Jaime | Zendy; Patrick Eberechi Akpaka | Zendy; Sehlule Vuma | Zendy; Angel A Justiz-Vaillant | Zendy

Open Access

A healthy patient with positive mantoux test but negative quantiferon Gold assay and no evidence of risk factors – to treat or not to treat?

Author(s) -

Lazara Karelia Montané Jaime,

Patrick Eberechi Akpaka,

Sehlule Vuma,

Angel A Justiz-Vaillant

Publication year - 2019

Publication title -

idcases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.319

H-Index - 13

ISSN - 2214-2509

DOI - 10.1016/j.idcr.2019.e00658

Subject(s) - medicine , mantoux test , quantiferon , tuberculin , isoniazid , vaccination , tuberculosis , asymptomatic , immunology , skin test , gold standard (test) , mycobacterium tuberculosis , pyrazinamide , dermatology , latent tuberculosis , pathology

A 56-year-old woman who vaccinated as a child with the Bacillus Calmette-Guerin (BCG), now tests positive to the tuberculin skin test (TST) but test negative to the Quantiferon Gold assay. She has no history of tuberculosis contact and is asymptomatic. This dilemma now is, should be treated for tuberculosis or not, based only on the TST results? To prevent these falsepositive results with TST and avoid treatment with isoniazid (INH) it may be helpful to use interferon-gamma release assay (IGRA) instead, which unlike the TB skin test is not affected by prior BCG vaccination.

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