In a recent editorial, Comstock1 said lean, underweight tuberculin reactors have a significantly higher risk of developing tuberculosis than persons above, or at, ideal body weight. Because many physicians may be unfamiliar with the data that support this assertion, a short review of the relevant literature seems appropriate.
The notion that a certain kind of body build predisposes a person to tuberculosis dates back at least to Hippocrates.2 In the early part of this century, Reed and Love3 studied US Army recruits before and during World War I and found that tuberculosis developed much more frequently among men who were tall and thin than those who were short and heavyset. This build was not thought to be a result of tuberculosis since it was present long before disease became clinically evident. Similar findings were reported by Long and Jablon4 among men entering the army during World
Snider DE. Tuberculosis and Body Build. JAMA. 1987;258(22):3299. doi:10.1001/jama.1987.03400220099047