title: Tuberculin skin test positivity without tuberculosis contact: A major challenge in childhood.
abstract: OBJECTIVE
  Worldwide, tuberculin skin tests (TSTs) commonly give false positive results for those who had been given the Bacillus-Calmette-Guerin vaccine such as is routinely administered in Turkey. This study aimed to evaluate the patients referred to us who had positive TSTs despite lack of tuberculosis (TB) disease contacts.
  
  
  METHODS
  Between September 2011 and September 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.
authors.affiliation: Division of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Gedik
authors.affiliation: Division of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Cakir
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Tugrul
authors.initials: T
authors.lastname: Donmez
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Ari
authors.affiliation: Molecular Tuberculosis Epidemiology Laboratory, Institute for Medical Experimental Research (DETAE), Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Orhan Kaya
authors.initials: OK
authors.lastname: Koksalan
mesh_terms: D000293:Adolescent; D001500:BCG Vaccine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis*; D014421:Turkey
chemical_list: D001500:BCG Vaccine
keywords: asthma; child; cough; tuberculin skin test; tuberculosis