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Tuberculin skin testing: present status

N K Murthy¹, A K Dutt

¹Medical Service, Alvin C. York VA Medical Center, Murfreesboro, TN 37130.

Seminars in Respiratory Infections

|June 1, 1994

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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.

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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.