PURIFIED PROTEIN DERIVATIVES PREPARED FROM MYCOBACTERIUM
TUBERCULOSIS (PPDs) AND M. INTRACELLULARE (PPD-B) INDIFFERENTIAL DIAGNOSIS OF MYCOBACTERIOSIS
1990 Volume 65 Issue 11 Pages 701-709
Details
1990 Volume 65 Issue 11 Pages 701-709
To reveal the possibility of differentiating diseases caused by M. tuberculosis and M. intracellulare, simultaneous tuberculin testing by PPDs and PPD-B was carried outamong X-ray suspects of tuberculosis and healthy persons.
PPD-B was prepared by Dr. Tasaka (Department of Bacteriology, Hiroshima University) from M. intracellulare (ATCC13950).
For tuberculin testing, 0.05μg of PPDs from M. tuberculosis (Nihon BCGCo.) and 0.1, μg of PPD-B were used.
The study included61patients with disease caused by M. tuberculosis (TB), 23 patients with that of M. avium complex (MAC) and 40 healthy persons with no roentgenologicalabnormality (H).
Forty healthy persons had been vaccinated with BCG. Statisticalanalysis of the diameter of reaction (redness) in each antigen in each group has been doneby Boxplotting method.
The results were as follows: 75% upper quartile point, median, 25%lower quartile point/mean S. D.: PPDs in TB (41.8, 30.0, 19.0/32.0-17.7) PPDB in TB (15.0, 10.5, 5.0/10.9 8.1) PPDs in MAC (26.0, 10.0, 7.0/16.4-13.9) PPDB in MAC (20.5, 17.5, 12.5/19.1-11.4) PPDs in H (18.0, 12.0, 6.0/13.5-10.9) PPDB in H (7.0, 2.8, 0.0/4.4-5.4).
Mean of PPDs in TB patients and PPD-B in MAC patients were significantly (P<0.01) larger than those in other groups. Significant differences of reaction by age distribution, previous history of mycobacteriosis or other diseaseswere not observed.
In each patient, larger skin test reaction correlated with the infected organism in 71 (85%) of the 84 cases.
In 61 patients with M. tuberculosis infection, reaction to PPDs waslarger than that of PPD-B in 58, and the reaction to PPD-B was larger than that of PPDs in only one subject, and the reaction to PPDs and PPD-B were smaller than 5mm in 2. In 23 patients with MAC infection, the reaction to PPD-B was larger than that of PPDs in 13, the reaction to PPDs was larger than that of PPD-B in8and the reaction to PPDs and PPD-B were smaller than 5mm in 2.
It is concluded that simultaneous skin test with PPDs and PPD-B is useful in thedifferential diagnosis of mycobacterial disease due to M. tuberculosis and M. aviumcomplex prior to bacteriologic confirmation by culture.
