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Patient of The Week

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Annette is a patient born in Argentina who I saw in consultation for Crohn’s disease. Like most people from that part of the world, she received the bacillus Calmette–Guérin, or BCG, vaccine against tuberculosis as a child. Since the vaccine is prepared from a strain of live tuberculosis that has lost its virulence in humans, one of the possible side effects is a false positive skin test for tuberculosis, which is exactly what happened to Annette when she was screened for tuberculosis in middle school. As a result of the positive test, she was treated for active tuberculosis infection with three antibiotics for a total of nine months, even though she never had any signs or symptoms of tuberculosis, and an X-ray of her lungs failed to show any evidence of the disease. In her senior year of high school Annette developed abdominal pain, diarrhea, and weight loss. She was…