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Tuberculin skin test positivity without tuberculosis contact: A major challenge in childhood
Author(s) -
Gedik Ahmet Hakan,
Cakir Erkan,
Donmez Tugrul,
Ari Engin,
Koksalan Orhan Kaya
Publication year - 2015
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12779
Subject(s) - medicine , tuberculosis , tuberculin , asthma , sputum , chronic cough , disease , pleural effusion , dermatology , medical diagnosis , pediatrics , surgery , pathology
Aim Worldwide, tuberculin skin tests ( TSTs ) commonly give false positive results for those who had been given the B acillus‐ C almette‐ G uerin vaccine such as is routinely administered in T urkey. This study aimed to evaluate the patients referred to us who had positive TSTs despite lack of tuberculosis ( TB ) disease contacts. Methods Between S eptember 2011 and S eptember 2012, 183 patients were prospectively evaluated for differential diagnosis of TST positivity despite lack of TB disease contact. They were then followed up by us to determine an accurate diagnosis. Results Among our patients' most common symptoms indicating a need for TST were chronic cough, productive cough or sputum expectoration, and recurrent or persistent wheezing. Chest x‐rays were taken of all patients, and the findings were noted. Interferon gamma release assays were performed on 75% of the patients, of which 96% were negative for TB . The most common final diagnoses were asthma (44%), allergic rhinitis (13%), bronchopneumonia (11%) and reactive lymphadenitis (6.5%). Further evaluations for TB were required of 36 patients, and TB disease was established in 12 of them (6.5%). Conclusions In patients who had had no known TB contact, the most common symptom indicating need for TST was chronic cough; the most common diagnoses were asthma and allergic rhinitis. Cavitary lesions, haemoptysis, persistent infiltration, pleural effusion and thoracic lymphadenopathy despite antibiotherapy should alert physicians to the possibility of TB .