How to Read a Tuberculosis Skin Test|how to read a tb skin test
What does the Mantoux vaccination look like?
The Mantoux test (the Mantoux reaction, the tuberculin test) is necessarily carried out to all children once a year, as well as to some adults according to indications. The Mantoux reaction can be set only by medical personnel who have completed special courses. It is an intradermal injection in the forearm. 0.1 ml of tuberculin solution is injected into the skin. A dense “button” should form at the injection site, which quickly disappears. After 3 days, the sample is evaluated. The diameter of the seal or redness is measured in millimeters. The results of the sample are recorded in the child's medical card.
A positive reaction is indicated if the diameter of the seal (infiltrate) at the injection site is from 5 to 16 mm. The larger the size of the papule, the more pronounced the reaction. Normally, the reaction will be positive after the BCG vaccination. However, if the child is not vaccinated, a positive test can talk about infection with tuberculosis and such a child requires further examination by a TB doctor.
Mantoux's questionable reaction is a seal at the site of a prick ranging in size from 2 to 4 mm and (or) the presence of redness of any size. Usually, a dubious test arises when a positive reaction “fades away” a few years after vaccination. This is a variant of the norm.
A hyperergic reaction is said if the size of the seal in children and adolescents is 17 mm and above, in adults - 21 mm and above. As a rule, this reaction indicates the disease of pulmonary tuberculosis.
A negative Mantoux test is the complete absence of any change in the skin at the injection site or the appearance of a seal no larger than 1 mm. A negative reaction is characteristic of non-vaccinated children who have never met with a tubercle bacillus. If the child is vaccinated, but the sample is negative, this may indicate that for some reason the immunity against tuberculosis has not been formed. Such children require re-vaccination. In addition, a negative reaction occurs in very severe forms of tuberculosis.
"Virage" of a tuberculin test is a spontaneous change in a negative reaction to a positive one, provided that the child has not been given a repeated vaccination of BCG. In addition, a "bend" indicates an increase in the positive reaction of 6 mm compared with the previous sample. The child must be further examined, there is a high likelihood of being infected with tuberculosis. Most likely, you will need to carry out an x-ray examination of the lungs, and if necessary, drink a course of special antibiotics.
Contraindications to the Mantoux test, too. These are all acute diseases and chronic in the period of exacerbation, allergic reactions, rheumatism, bronchial asthma in the acute stage. You can not carry out the Mantoux reaction in institutions where there is a quarantine for childhood infections. Mantoux test is carried out only 1 month after prophylactic vaccinations.
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