Tuberculosis makes a comeback. Giving and interpreting the Mantoux test.

Tuberculosis is on the increase in the United States, so physicians would be prudent to renew familiarity with the disease. Physicians should be prepared to administer the Mantoux test correctly and interpret the results according to the specific condition of each patient. Patients with certain diseases (eg, chronic renal failure, lymphoid disorders) are likely to be anergic but are also more likely than other persons to have tuberculosis. In these patients, the goal is to administer the test before they become anergic, so infection can be identified if it occurs. Preventive therapy is useful in some situations (eg, when public health is a factor) and should also be chosen on the basis of the individual patient, weighing the risk of disease against the risk of drug toxicity.