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Clinical Crossroads Update
January 22/29, 2003

A 52-Year-Old Man With a Positive PPD, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2003;289(4):476. doi:10.1001/jama.289.4.476

In a Clinical Crossroads article published in November 2001, Michael Iseman, MD, discussed a 52-year-old man, Mr Z, who had recently returned from Bangladesh, an area endemic for tuberculosis (TB), with a dry, hacking cough.1 His purified protein derivative (PPD) test yielded a positive result with 22 × 28 mm of induration; a chest radiograph was normal. His primary care physician, Dr L, was not convinced that the positive PPD represented a recent conversion to TB, and, after considering with the patient the potential risks of treatment, elected not to treat him at that time.

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