title: The risk for transmission of Mycobacterium tuberculosis at the bedside and during autopsy.
abstract: OBJECTIVE
  To emphasize the differing infectious potentials of a patient with tuberculosis.
  
  
  METHODS
  Hospital ward and autopsy room.
  
  
  METHODS
  An epidemiologic investigation of tuberculin skin test conversions in a clinical setting and during autopsy when results of tuberculin tests done before exposure were available for all participants.
  
  
  METHODS
  Tuberculin skin test results after the discovery of tuberculosis exposure from a patient with unsuspected tuberculosis for comparison with the test results before exposure; culture of sputum and autopsy material for Mycobacterium tuberculosis; and DNA fingerprinting of organisms.
  
  
  METHODS
  Preventive therapy for persons with skin test conversion.
  
  
  RESULTS
  None of the 40 skin test-negative health care workers caring for the patient for 3 weeks on an open medical ward showed a skin test conversion, even though they had not used respiratory precautions. By contrast, among personnel present during the 3-hour autopsy, the test results of all five nonreactors converted from negative to positive (mean reaction, 24 mm). Two of these persons had a positive sputum culture 8 weeks later. The DNA fingerprints of all three isolates were identical.
  
  
  CONCLUSIONS
  A patient who did not transmit tuberculosis before death released a prodigious number of tubercle bacilli during autopsy.
authors.affiliation: John L. McClellan Veterans Administration Hospital, Little Rock, Arkansas, USA.
authors.forename: G L
authors.initials: GL
authors.lastname: Templeton
authors.forename: L A
authors.initials: LA
authors.lastname: Illing
authors.forename: L
authors.initials: L
authors.lastname: Young
authors.forename: D
authors.initials: D
authors.lastname: Cave
authors.forename: W W
authors.initials: WW
authors.lastname: Stead
authors.forename: J H
authors.initials: JH
authors.lastname: Bates
mesh_terms: D000391:Air Microbiology; D001344:Autopsy; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010564:Personnel, Hospital; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000635:transmission*; D014691:Ventilation