Six Mantoux tuberculin skin tests with 1,2,5,10,20, and 50 units in a healthy male without side-effects - Is skin reaction a linear function of tuberculin dose?

Abstract

Background: Tuberculosis remains a serious disease worldwide. Anti-tuberculosis campaigners many times face negative tuberculin skin tests after Bacille Calmette Guérin vaccination. Increasing tuberculin units might be a solution. However, is skin reaction a linear function of tuberculin dose? Are there any side-effects when higher tuberculin doses are administered?. Case presentation: Six simultaneous Mantoux tuberculin skin tests, using 1, 2, 5, 10, 20, and 50 tuberculin units (88 altogether) of purified protein derivative RT23 per 0.1 mL were applied in a healthy male Greek 35-years-old, with known natural Mycobacterium tuberculosis primary infection since five years. Skin indurations 72 hours later were 15, 22, 23, 19, 23, and 27 mm respectively. Conclusion: No linear relation between tuberculin dose and skin reaction observed; skin reaction increased as tuberculin dose increased but with a decreasing rate, especially after 2 TUs, which seem correctly defined for detection of natural infection. No side-effects occurred.