TUBERCULIN-NEGATIVE TUBERCULOSIS

Abstract

After discussing in general terms reactivity to tuberculin and citing some 10 circumstances in which tuberculin negativity may be found, the author addresses himself to case material in which active tuberculosis was proved to be present and yet the tuberculin test was inexplicably negative. Of 11 such cases, 6 were proved tuberculous by culture of Mycobacterium tuberculosis, 2 were certified by recovery of typical acid-fast bacilli from sputum, and 3 had convincing signs and symptoms although bacteriologic proof was lacking. Attempts were made to elucidate the reason and nature of their tuberculin negativity by vaccination with BCG and virulent tubercle bacilli, by general tests for skin reactivity and procedures designed to reveal anticutins. Nothing was uncovered to account for the tuberculin negativity. It is left that such cases do occur in very small percentage, that they constitute an immunologic mystery and that the phenomenon is a small epidemiologic hazard if case finding depends solely on tuberculin testing.