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Erin E. Hartman, MS; Tom Delbanco, MD
From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2003;289:476.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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 x 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.

Dr Iseman reviewed the history and epidemiology of TB. He discussed the limitations of the tuberculin skin test in terms of problems interpreting results and diagnosing latent TB infection. He explained the current guidelines for use of the tuberculin skin test and the efficacy of various treatments for . . . [Full Text of this Article]

DR L, THE PRIMARY CARE PHYSICIAN