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Having been vaccinated with the BCG during my training in England, I would 
say he still needs treatment. From what I recall, the BCG vaccine has only 
been shown to reduce the chance of TB meningitis, not any other form of TB. 
Secondly, individual response to BCG vaccine is variable so tuberculine 
testing in this setting is not reliable enough to state that the patient has 
past immunitiy from the BCG vaccine. Therefore, any BCG vaccinated patient 
with exposure to TB should be treated as a positive infection.

Hope my opinion helps.

Jason

Jason Foland, MD
Clinical Associate Professor of Pediatrics
Florida State University School of Medicine
Medical Director of Pediatric Respiratory Care
Pediatric ICU
Sacred Heart Children's Hospital
Pensacola, Florida

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From: "emad el sherbiny" <[log in to unmask]>
Sent: Thursday, April 15, 2010 4:08 AM
To: <[log in to unmask]>
Subject: TB

> Dear all
>
> 20 years old , vaccinated at age of 3 months with BCG vaccine, now at the
> age of 20 years has a postive tuberculine test of 25 mm done cause he has
> been exposed to a case of open TB 2 weeks ago, clinically well, CXR
> unremarkable
>
> the question ? does he need treatment or may be due to the previuos 
> vaccine
>
> For more information, send mail to [log in to unmask] with the 
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                 http://listserv.brown.edu/ped-em-l.html
> 

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html