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Tuberculin skin testing: present status
1Medical Service, Alvin C. York VA Medical Center, Murfreesboro, TN 37130.
Seminars in Respiratory Infections
|June 1, 1994
Summary
Tuberculosis incidence is rising, increasing the need for early detection. Tuberculin skin testing is a key diagnostic tool, but requires careful interpretation due to potential false reactions.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) incidence increased by 18% between 1985 and 1992, with projections indicating a continued rise.
- This trend necessitates renewed focus on early TB detection and prevention strategies.
- Tuberculin skin testing (TST) is a crucial diagnostic method for TB detection, control, and elimination.
Purpose of the Study:
- To review the fundamental immunology of tuberculin skin testing.
- To provide guidance on the proper technique and interpretation of TST results.
- To outline the indications for utilizing TST in clinical practice.
Main Methods:
- The article reviews existing literature and established protocols for tuberculin skin testing.
- It discusses the immunological basis of delayed hypersensitivity reactions elicited by TST.
- It addresses common challenges such as cross-reactivity and false-negative results.
Main Results:
- Tuberculin skin testing relies on delayed hypersensitivity to mycobacterial antigens.
- TST results can be confounded by cross-reactions with non-tuberculous mycobacteria.
- False-negative reactions are a significant limitation requiring clinical correlation.
Conclusions:
- Tuberculin skin testing remains a valuable tool for tuberculosis diagnosis and management.
- Accurate interpretation of TST requires consideration of the individual's overall clinical context.
- Understanding TST immunology and potential pitfalls is essential for effective use.