A healthy patient with positive mantoux test but negative quantiferon Gold assay and no evidence of risk factors - to treat or not to treat?

一名健康患者,结核菌素试验呈阳性,但抗结核菌素释放试验(QuantiFERON-TB Gold)呈阴性,且无危险因素——是否需要治疗?

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Abstract

A 56-year-old woman who vaccinated as a child with the Bacillus Calmette-Guerin (BCG), now tests positive to the tuberculin skin test (TST) but test negative to the Quantiferon Gold assay. She has no history of tuberculosis contact and is asymptomatic. This dilemma now is, should be treated for tuberculosis or not, based only on the TST results? To prevent these falsepositive results with TST and avoid treatment with isoniazid (INH) it may be helpful to use interferon-gamma release assay (IGRA) instead, which unlike the TB skin test is not affected by prior BCG vaccination.

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