Ninety-one children were Mantoux-tested using O.T. in a dilution of 1:10,000 (.01 mg.). Negative reactors were retested with a 1:100 (1.0 mg.) solution of O.T.All the children were then tested by making two punctures through a drop of BCG vaccine applied to the arm. The Mantoux-positive group developed papules during the first six days after inoculation with BCG. The tuberculin-negative individuals showed a late reaction to BCG in 12 to 20 days, similar to that seen in tuberculosis uninfected individuals when BCG vaccinated by the method of Rosenthal or Birkhaug. In four cases false "positives" were elicited with O.T. These were easily differentiated by the demonstration of a late reaction with the BCG test. Thirty-four of the negative reactors were rechecked one year later and showed no change in their status as a result of the BCG test.It is true, of course, that the number of children studied in this series is too small to justify any final conclusions about the role of BCG in routine tuberculin testing. The authors feel, however, that the findings together with the findings of other investigators indicate that BCG vaccine is a more sensitive and more specific test than the ordinary tuberculin test and it therefore should be of value in the following situations:1. Where the authenticity of a "positive tuberculin test" is doubted.2. In cases of tuberculin anergy where clinical evidence seems to indicate tuberculous infection despite a negative tuberculin test.3. To detect infratuberculin allergy when BCG vaccination is contemplated. Further research is necessary to determine whether BCG vaccination is necessary in the presence of infratuberculin allergy.
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