Aj. Daley et D. Isaacs, Differential avian and human tuberculin skin testing in non-tuberculous mycobacterial infection, ARCH DIS CH, 80(4), 1999, pp. 377-379
Objective-To determine the sensitivity of differential avian and human dela
yed type hypersensitivity skin testing in the diagnosis of non-tuberculous
mycobacterial lymphadenitis.
Method-Retrospective review of all patients with culture proved nontubercul
ous mycobacterial lymph node infections who also had differential avian and
human skin testing performed over a 10 year period from 1986 to 1996.
Results-One hundred and twenty four patients had non-tuberculous mycobacter
ia isolated from lymph nodes over this period, 59 of whom had differential
skin testing performed. The sensitivity of a response of greater than or eq
ual to 10 mm to the avian precipitin was 58 of 59. No patient had both a ne
gative human and avian Mantoux. The sensitivity of the human Mantoux alone
for diagnosing non-tuberculous mycobacterial infection was 81% for a respon
se of greater than or equal to 5 mm and 66% for greater than or equal to 10
mm. Ten patients had a 0 human response. Fifty five of the 59 patients had
an avian response at least 2 mm greater than the human response.
Conclusion-The avian Mantoux is a very sensitive method of diagnosing nontu
berculous mycobacterial infection in children. The human Mantoux is not sen
sitive enough to be used alone as a surrogate to diagnose non-tuberculous m
ycobacterial infection.