title: Repeatedly negative tuberculin skin tests followed by active tuberculosis in an immunocompetent individual.
abstract: We describe a woman who was repeatedly tuberculin (PPD) skin test negative after exposure to smear-positive tuberculosis (TB), but developed active TB with a positive skin test 7 years later. Molecular epidemiologic evidence is presented that the infection was contracted 7 years previously from the original source case. PPD skin testing is subject to many technical and biological variables and this report underscores that this tool can fail to detect latent TB infection in some cases. The causes of false-negative and false-positive PPD skin test results are reviewed.
authors.affiliation: Department of Infectious Diseases, C5P, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. s.m.arend@lumc.nl
authors.forename: S M
authors.initials: SM
authors.lastname: Arend
authors.forename: D
authors.initials: D
authors.lastname: van Soolingen
authors.forename: T H
authors.initials: TH
authors.lastname: Ottenhoff
authors.forename: J T
authors.initials: JT
authors.lastname: van Dissel
mesh_terms: D000208:Acute Disease; D000328:Adult; D016358:Contact Tracing; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology / Q000635:transmission