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April 1967, Vol 113, No. 4 >
Article | April 1967

Tuberculosis and Varicella Infections in Children FREE

Mark A. Belsey, MD
[+] Author Affiliations

Received for publication May 27, 1966.

Reprint requests to 1430 Tulane Ave, New Orleans 70112 (Dr. Belsey).

PPD-RT-23 is a standardized tuberculin which was prepared in a quantity for 33 billion tests. Among specific reactors to tuberculin, 2.5 tuberculin units (TU) of RT-23 with Tween 80 is equivalent to 5 TU of PPD-S.


Am J Dis Child. 1967;113(4):444-448. doi:10.1001/archpedi.1967.02090190090007.
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References
Comments

VARICELLA has not been known to affect the course of tuberculosis in children despite suppression of the tuberculin reaction during varicella.1-3 Although altered radiologic findings in children with primary tuberculosis complicated by varicella have been described, these changes have been attributed to varicella pneumonia rather than to alteration of the tuberculous process.4,5

An outbreak of varicella in the children's Tuberculosis Ward of the San Francisco General Hospital permitted close observation of the effect of varicella on tuberculosis.

Laboratory Studies  Tuberculin skin tests were performed on all patients on admission. On the second to fourth day of varicella rash, a tuberculin test was placed on the left forearm by me using 0.1 ml of standard RT-23 Purified Protein Derivative (0.02 μg PPD/0.1 ml*),6 and read by me 48 hours later. I repeated tuberculin tests on the right forearm one month later using the same lot of RT-23 PPD.

REFERENCES

1 +
Eddy, B., and Mitchell, A.G.:  Studies in Immunity: II. The Effect on the Skin Tuberculin Reaction of Nonspecific Factors , Amer J Dis Child 40:771, 1930;.
2 +
Mitchell, A.G.; Nelson, W.E.; and LeBlanc, T.J.:  Studies in Immunity: Effect of Acute Diseases on the Reaction of the Skin to Tuberculin , Amer J Dis Child 49:693, 1935;.
3 +
Starr, S., and Berkovich, S.:  The Depression of Tuberculin Reactivity During Chickenpox , Pediatrics 33:769, 1964;.
4 +
Combe, P.; Boineau, N.; and Zannettacci, M.:  Manifestations pulmonaires de le varicelle au cours de la primoinfection tuberculeuse du nourrisson , Pediatrie 14:503, 1959;.
5 +
Gerbeaux, J., and Cremer, V.:  Aspects radiologiques des localisations pulmonaires au cours de la varicelle , J Radiol Electr 45:398, 1964;.
6 +
Comstock, G.W., et al:  A Comparison in the United States of America of Two Tuberculins, PPD-S and RT 23 , Bull WHO 31:161, 1964;.
7 +
Von Pirquet, C.:  Das Verhalten der kutanen Tuberkulin-reaktion wakrend der Masern , Deutsche Med Wschr 34:1297, 1908;.
8 +
Bentzon, J.W.:  The Effect of Certain Infectious Diseases on Tuberculin Allergy , Tubercle 34:34, 1953;.
9 +
Bloomfield, A.L., and Mateer, J.G.:  Changes in Skin Sensitiveness to Tuberculin During Epidemic Influenza , Amer Rev Tuberc 3:166, 1919;.
10 +
Brody, J.A., and McAlister, R.:  Depression of Tuberculin Sensitivity Following Measles Vaccination , Amer Rev Resp Dis 90:607, 1964;.
11 +
Brody, J.A.; Overfield, T.; and Hammes, L.M.:  Depression of the Tuberculin Reaction by Viral Vaccines , New Eng J Med 271:1294, 1964;.
12 +
Westwater, S.S.:  Tuberculin Allergy in Acute Infectious Diseases: A Study of the Intracutaneous Test , Quart J Med 4:203, 1935;.
13 +
Bertoye, A., and Fournier, P.:  Place et role des affections virales au course de la primo-infection tuberculeuse de l'enfant , J Med Lyon (Jan 20) 1958;, p 151.
14 +
Seeberg, G.:  Intradermal Reactions of the Delayed Type in Relation to the Absorptive Behavior of the Skin , Acta Derm Atovener (Stockholm) 27: (suppl 18) , pp 1-149, 1947;.
15 +
Pilcher, J.D.:  Diminution in the Circulation of the Skin: A Factor in Decreasing the Cutaneous Tuberculin Reaction , Amer Rev Tuberc 21:669, 1930;.
16 +
Seeberg, G.:  Skin Sensitivity in Scarlatina, Rubella, and Morbilli , Acta Derma Atovener (Stockholm) 31:435, 1951;.
17 +
Wiseman, B.K., and Doan, C.A.:  The Lymphatic Reaction in Tuberculosis , Amer Rev Tuberc 30:33, 1934;.
18 +
Turk, J.L.:  The Passive Transfer of Delayed Hypersensitivity in Guinea Pigs by the Transfusion of Isotopically-Labelled Lymphoid Cells , Immunology 5:478, 1962;.
19 +
Nalbant, J.P.:  The Effect of Contagious Diseases on Pulmonary Tuberculosis and on the Tuberculin Reaction in Children , Amer Rev Tuberc 36:773, 1937;.
20 +
Mitchell, G.F.:  Streptococcus Throat Infections in Tuberculous Children , Amer Rev Tuberc 36:778, 1937;.
21 +
Rossini, A., and Fattort, A.:  Contagious Diseases in Children With Primary Tuberculosis , Clin Pediat 34:409, 1952;;
22 +
(abstracted, Amer J Dis Child 86:78, 1953;)
23 +
Duboezy, B.O.:  Repeated Tuberculin Tests at the Same Site in Tuberculin-Positive Patients , Amer Rev Resp Dis 90:77, 1964;.
24 +
Blatman, S.; Perez, D.; and Alexander, H.E.:  Primary Pulmonary Tuberculosis in Young Children: Microbiological, X-ray and Tuberculin Allergy Evaluation , Amer J Dis Child 100:697, 1960;.

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References

1 +
Eddy, B., and Mitchell, A.G.:  Studies in Immunity: II. The Effect on the Skin Tuberculin Reaction of Nonspecific Factors , Amer J Dis Child 40:771, 1930;.
2 +
Mitchell, A.G.; Nelson, W.E.; and LeBlanc, T.J.:  Studies in Immunity: Effect of Acute Diseases on the Reaction of the Skin to Tuberculin , Amer J Dis Child 49:693, 1935;.
3 +
Starr, S., and Berkovich, S.:  The Depression of Tuberculin Reactivity During Chickenpox , Pediatrics 33:769, 1964;.
4 +
Combe, P.; Boineau, N.; and Zannettacci, M.:  Manifestations pulmonaires de le varicelle au cours de la primoinfection tuberculeuse du nourrisson , Pediatrie 14:503, 1959;.
5 +
Gerbeaux, J., and Cremer, V.:  Aspects radiologiques des localisations pulmonaires au cours de la varicelle , J Radiol Electr 45:398, 1964;.
6 +
Comstock, G.W., et al:  A Comparison in the United States of America of Two Tuberculins, PPD-S and RT 23 , Bull WHO 31:161, 1964;.
7 +
Von Pirquet, C.:  Das Verhalten der kutanen Tuberkulin-reaktion wakrend der Masern , Deutsche Med Wschr 34:1297, 1908;.
8 +
Bentzon, J.W.:  The Effect of Certain Infectious Diseases on Tuberculin Allergy , Tubercle 34:34, 1953;.
9 +
Bloomfield, A.L., and Mateer, J.G.:  Changes in Skin Sensitiveness to Tuberculin During Epidemic Influenza , Amer Rev Tuberc 3:166, 1919;.
10 +
Brody, J.A., and McAlister, R.:  Depression of Tuberculin Sensitivity Following Measles Vaccination , Amer Rev Resp Dis 90:607, 1964;.
11 +
Brody, J.A.; Overfield, T.; and Hammes, L.M.:  Depression of the Tuberculin Reaction by Viral Vaccines , New Eng J Med 271:1294, 1964;.
12 +
Westwater, S.S.:  Tuberculin Allergy in Acute Infectious Diseases: A Study of the Intracutaneous Test , Quart J Med 4:203, 1935;.
13 +
Bertoye, A., and Fournier, P.:  Place et role des affections virales au course de la primo-infection tuberculeuse de l'enfant , J Med Lyon (Jan 20) 1958;, p 151.
14 +
Seeberg, G.:  Intradermal Reactions of the Delayed Type in Relation to the Absorptive Behavior of the Skin , Acta Derm Atovener (Stockholm) 27: (suppl 18) , pp 1-149, 1947;.
15 +
Pilcher, J.D.:  Diminution in the Circulation of the Skin: A Factor in Decreasing the Cutaneous Tuberculin Reaction , Amer Rev Tuberc 21:669, 1930;.
16 +
Seeberg, G.:  Skin Sensitivity in Scarlatina, Rubella, and Morbilli , Acta Derma Atovener (Stockholm) 31:435, 1951;.
17 +
Wiseman, B.K., and Doan, C.A.:  The Lymphatic Reaction in Tuberculosis , Amer Rev Tuberc 30:33, 1934;.
18 +
Turk, J.L.:  The Passive Transfer of Delayed Hypersensitivity in Guinea Pigs by the Transfusion of Isotopically-Labelled Lymphoid Cells , Immunology 5:478, 1962;.
19 +
Nalbant, J.P.:  The Effect of Contagious Diseases on Pulmonary Tuberculosis and on the Tuberculin Reaction in Children , Amer Rev Tuberc 36:773, 1937;.
20 +
Mitchell, G.F.:  Streptococcus Throat Infections in Tuberculous Children , Amer Rev Tuberc 36:778, 1937;.
21 +
Rossini, A., and Fattort, A.:  Contagious Diseases in Children With Primary Tuberculosis , Clin Pediat 34:409, 1952;;
22 +
(abstracted, Amer J Dis Child 86:78, 1953;)
23 +
Duboezy, B.O.:  Repeated Tuberculin Tests at the Same Site in Tuberculin-Positive Patients , Amer Rev Resp Dis 90:77, 1964;.
24 +
Blatman, S.; Perez, D.; and Alexander, H.E.:  Primary Pulmonary Tuberculosis in Young Children: Microbiological, X-ray and Tuberculin Allergy Evaluation , Amer J Dis Child 100:697, 1960;.

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