Gary L. Templeton, MD; Lee Ann Illing, RN, CIC; Lanne Young, MD; Donald Cave, PhD; William W. Stead, MD, MACP; Joseph H. Bates, MD, MACP
To emphasize the differing infectious potentials of a patient with tuberculosis.
Hospital ward and autopsy room.
An epidemiologic investigation of tuberculin skin test conversions in a clinical setting and during autopsy when results of tuberculin tests done before exposure were available for all participants.
Tuberculin skin test results after the discovery of tuberculosis exposure from a patient with unsuspected tuberculosis for comparison with the test results before exposure; culture of sputum and autopsy material for Mycobacterium tuberculosis; and DNA fingerprinting of organisms.
Preventive therapy for persons with skin test conversion.
None of the 40 skin test-negative health care workers caring for the patient for 3 weeks on an open medical ward showed a skin test conversion, even though they had not used respiratory precautions. By contrast, among personnel present during the 3-hour autopsy, the test results of all five nonreactors converted from negative to positive (mean reaction, 24 mm). Two of these persons had a positive sputum culture 8 weeks later. The DNA fingerprints of all three isolates were identical.
A patient who did not transmit tuberculosis before death released a prodigious number of tubercle bacilli during autopsy.
Templeton GL, Illing LA, Young L, Cave D, Stead WW, Bates JH. The Risk for Transmission of Mycobacterium tuberculosis at the Bedside and during Autopsy. Ann Intern Med. ;122:922–925. doi: 10.7326/0003-4819-122-12-199506150-00005
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Published: Ann Intern Med. 1995;122(12):922-925.
Infectious Disease, Mycobacterial Infections.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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