Differential avian and human tuberculin skin testing in non-tuberculous mycobacterial infection
Department of
Immunology and Infectious Diseases, Royal Alexandra Hospital for
Children, Westmead, NSW 2145, Australia
Correspondence to: Dr A J Daley, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia. email: andrewd{at}icpmr.wsahs.nsw.gov.au
Accepted 28 October
1998
OBJECTIVE
To determine
the sensitivity of differential avian and human delayed-type
hypersensitivity skin testing in the diagnosis of non-tuberculous
mycobacterial lymphadenitis.
METHODRetrospective
review of all patients with culture proved non-tuberculous
mycobacterial lymph node infections who also had differential avian and
human skin testing performed over a 10 year period from 1986 to 1996.
RESULTSOne hundred
and twenty four patients had non-tuberculous mycobacteria isolated from
lymph nodes over this period, 59 of whom had differential skin testing
performed. The sensitivity of a response of 
10 mm to the avian
precipitin was 58 of 59. No patient had both a negative human and avian
Mantoux. The sensitivity of the human Mantoux alone for diagnosing
non-tuberculous mycobacterial infection was 81% for a response of
5 mm and 66% for 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.
CONCLUSIONThe avian
Mantoux is a very sensitive method of diagnosing non-tuberculous
mycobacterial infection in children. The human Mantoux is not
sensitive enough to be used alone as a surrogate to diagnose
non-tuberculous mycobacterial infection.
© 1999 by Archives of Disease in Childhood
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