This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
False-negative tuberculin test is seen in all except: 
Select and explain. 
A. After 4-6 weeks of measles attack, B. Immunodeficiency state, C. Miliary tuberculosis, D. Atypical mycobacterial infection
D: Atypical mycobacterial infection
Answer: D: Atypical mycobacterial infection 
Explanation: • Positive: A positive tuberculin test indicates hypersensitivity to tuberculoprotein, denoting infection with the tubercle bacilli or prior immunisation with BCG. The test becomes positive 4-6 weeks after infection or immunisation. Tuberculin allergy wanes gradually and disappears after 4-5 years in the absence of subsequent contact with the mycobacteria. In endemic areas, the allergy is maintained by repeated contacts with the bacilli. 
• Negative: Persons who have never had contact or been exposed to the tubercle bacilli are tuberculin-negative negative tests (anergy) may be seen in miliary tuberculosis, convalescence from some viral infections like measles, lymphoreticular malignancy, sarcoidosis, severe malnutrition, immunosuppressive therapy or impaired cell-mediated immunity. 
• False negative results may also be due to inactive PPD preparations and improper injection technique. 
• False positive reactions may be seen in infections with some relatated mycobacteria ('atypical' mycobacteria). 
 
Ref: Ananthanarayana 8th ed page 360