Management of tuberculin reactors in children and adolescents previously vaccinated with BCG

Between 1960 and 1981, 142 Bacillus Calmette-Guérin (BCG)-vaccinated children and adolescents were evaluated in the Children's Chest Clinic, Bellevue Hospital. These patients came from 28 countries and had positive tuberculin reactions and/or exposure to active tuberculosis. Antituberculous therapy was given to 8 with active tuberculosis, to 8 with calcified pulmonary primary lesions and to 105 positive tuberculin reactors without disease. In a 1 1/2- to 16-year follow-up no tuberculous disease occurred, and two patients with previously negative roentgenograms developed calcified pulmonary lesions. Guidelines are given for the management of patients previously vaccinated with BCG with special reference to the value of prophylactic isoniazid therapy for those considered infected by Mycobacterium tuberculosis but without evidence of disease.