AALFRED I. KAPLAN, M.D. M.P.H., F.A.C.P.
To the editor: Fisher's letter in the December issue (Ann Intern Med 87:792, 1977) on tuberculosis after gastrointestinal surgery contains some misinformation about tuberculosis and its pathogenesis and demonstrates some of the problems noted by Byrd (1) that emerge as tuberculosis re-enters the mainstream of medicine from its relative isolation in sanitoria.
That contact with an active case of tuberculosis could not be established in Fisher's 57-year-old diabetic patient who had a positive reaction (12 mm) to PPD preoperatively is not surprising. For uncertain reasons the patient reactivated his initial (old) tuberculous infection manifested by the positive PPD in the
KAPLAN AI. Tuberculosis and Gut Surgery. Ann Intern Med. ;88:578–579. doi: 10.7326/0003-4819-88-4-578_2
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Published: Ann Intern Med. 1978;88(4):578-579.
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