The loss of tuberculin sensitivity in certain patients with active pulmonary tuberculosis.

he tuberculin test, widely used as a diagnostic had been used. An area of induration 5 mm or more in T aid in detecting cases of tuberculosis, is not diameter was considered a positive reaction. Maybury Sanatorium was maintained by the City of In rare instances patients with active Detroit strictly as a tuberculosis facility. Patients were sent tuberculosis may be tuber~ulin-negative.l*~ AS statthere because of a definite of tuberculosis or ed in one well-&own textbooks "i;atients criticallv because of an abnormal chest r&tgenogram suspected of ill with tuberculosis or other diseases, and especial$ being caused by tuberculosis. During the 2Zyear period from January 1, 1947 to January 1, 1969, the sanatorium patients with effusion of the pleura, had 9,974 newly admitted patiats whose tuberculin sen+ pericardiurn, meninges, or peritoneum may fail to tivity was studied. react to tuberculin. . .". With today's effective chemF~WLTS otherapy a case of pulmonary tuberculosis in which the patient is unable to react to tuberculin is most unusual, but the fact that such cases do occur must be recognized. Data gathered at the William H. Maybury Sanatorium over the past three decades make it possible to recognize certain clinical and pathologic characteristics of far-advanced tuberculosis which are associated with the loss of tuberculin sensitivity.