What is the interpretation of two IGRAs with negative mitogen wells, in the absence of immunosuppression?

If I understand this case correctly, the patient is actively ill and the patient's doctors are considering tuberculosis as a possible etiology of the patient's illness. In that scenario, IGRAs and PPDs have a limited to no role. Epidemiology, family history, and other possible exposures do. In your ...

In both scenarios, you have an indeterminate test result. Even without immunosuppression a small fraction of people have indeterminate results, and in active TB that percentage is larger.

In scenario 1, if you are concerned about active TB based on exposure or epidemiology, you should pursue testing...

An IGRA mitogen well serves as a positive control. The nil well detects what I call interfering immunologic activity. It is supposed to be greater than or equal to 8.0 IU/mL to be considered valid. The value (assuming it is less than or equal to 8) is subtracted from the TB well before the TB value ...