A client was infected with TB 10 years ago but never developed the disease. He’s now being treated for cancer. The client begins to develop signs of TB. This is known as which of the following types of infection?
A. Active infection
B. Primary infection
C. Superinfection
D. Tertiary infection
Correct Answer: A. Active infection
Some people carry dormant TB infections that may develop into active disease. In addition, primary sites of infection containing TB bacilli may remain inactive for years and then activate when the client’s resistance is lowered, as when a client is being treated for cancer. There’s no such thing as tertiary infection, and superinfection doesn’t apply in this case.
Option B: Primary (initial) infection is usually indicated by tuberculin skin test (TST) or interferon-gamma release assay (IGRA) conversion, which reflects a delayed type hypersensitivity reaction to protein products of M. tuberculosis. Primary infection remains undiagnosed in the majority of cases, as symptoms are mild, non-specific, and usually self-resolving.
Option C: Superinfection is the process by which a cell that has previously been infected by one virus gets co-infected with a different strain of the virus, or another virus, at a later point in time. Viral superinfections may be resistant to the antiviral drug or drugs that were being used to treat the original infection.
Option D: There is no tertiary infection in tuberculosis. A re-infection event probably triggers very similar responses to those observed with primary (first-time) infection and the risk of subsequent disease progression seems to be substantially reduced. However, re-infection is likely to occur multiple times during the lifetime of an individual living in a TB endemic area, which explains its large contribution to the disease burden observed.
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