Mantoux test - Causes, Symptoms and Treatment .MF .
Mantoux test (tuberculin test, PPD test, PPD test) - is a method for determining the intensity of immunity to the tuberculosis pathogen.
sample is introduced into the region of the inner surface of the forearm special preparation - tuberculin which is a purified product derived from Mycobacterium tuberculosis after special processing.
Why spend Mantoux test?
first vaccination against tuberculosis - BCG - is carried out in the first 3-7 days of life.However, the BCG vaccine does not always provide sufficient immunity to prevent infection.To determine whether the immunity against TB is effective, the Mantoux test is conducted annually.According to the results of the sample produce a selection of children for revaccination, held at 7 and 14-15 years.The epidemiologically disadvantaged areas with a high prevalence of TB revaccination is carried out in the 6-7, 11-12 and 16-17 years.
Additionally, the Mantoux test allows to identify infected persons and to begin timely treatment.
How is the Mantoux test
Mantoux test is conducted annually, regardless of the results of previous trials.The middle third of the inner surface of the forearm is introduced 0,1 ml of the preparation that contains two tuberculin units (TU).After the introduction of the tuberculin formed a small hillock, which is called "a button".
Can watering Mantoux test the water?
bathe, take a shower possible.You can not swim in the open water, so as not to infect the wound.Nor can rub this place a washcloth, as well as use any liquids and solutions: Zelenka, iodine, peroxide, it is impossible to seal the wound with plaster.You also need to make sure that the child is not combed wound.All of these can affect the result of the sample and lead to false positive results.
After the introduction of tuberculin in the presence of antibodies in the body against TB, at the site of the inflammatory response is generated - protective antibody fragments react with the pathogen.At the same time about 2-3 days after injection at the injection site formed a small mound of red, raised above the skin, dense to the touch, blanching with pressure.
results are assessed on day 3.To do this, make measurement of the diameter of the papules (tubercle) transparent ruler in good light.It measures not the size of redness and size of the seal.
· negative reaction - if there is no reaction at all or reaction ukolochnaya - 0-1mm
· Reaction questionable - if there is only redness without papules or papules the size does not exceed 2-4mm
· Positive reaction - if the size of papules 5mm or more.When the amount of infiltration 5-9mm - reaction is considered mild, with size 10-14mm - medium intensity, 15-16mm - a reaction expressed
· Reaction hyperergic (excessive) - if the papule diameter greater than 17mm in children and adolescents, and 21mm in adults.And if there are any signs of severe inflammation -. Abscesses, inflammation of the surrounding lymph nodes and other
negative test indicates the absence of antibodies in the body against the tubercle bacillus.This indicates the absence of infection, as well as the lack of reaction to a previous BCG vaccination.
dubious sample is actually equal to the negative.
positive test may indicate an infection by Mycobacterium tuberculosis or TB tension immunity after vaccination.To distinguish one state from another is not always easy.
in favor of infection with a positive Mantoux test show:
· first appeared positive reaction after a negative or questionable results in previous years
· Increase papules on 6mm or more in comparison with the previous year
· Positive reaction to infiltrate 10 mmmore over 3-5 years in a row (except for some cases of allergic reactions to PPD)
· hyperergic reaction
· Diameter 12 mm papules over 3-5 years after vaccination
· The presence of risk factors for infection: contact with TB patients,It is in the endemic region, low socio-economic status.
What to do when a positive sample?
If the sample was evaluated as positive or hyperergic and ibyli excluded possible influence immunity after the vaccine is recommended consultation phthisiatrician, which holds a number of additional studies for the diagnosis of primary tuberculosis: X-ray of the chest, microbiological examination of sputum to identify Mycobacterium tuberculosis,examination of family members and others. In the event that after a full examination of any signs of infection not found possible to estimate the positive sample or hyperergic as an allergic reaction to the tuberculin.This conclusion has the right to do just tuberculotherapist (for tuberculosis specialist).
Contra staging Mantoux test
· Skin diseases
· Acute infectious diseases or exacerbation of chronic diseases.The sample is placed in a month after the disappearance of all symptoms.
· Allergic conditions
· Quarantine in institutions.The sample can be placed within a month after the lifting of quarantine.
influence of other vaccinations
not place Mantoux test in one day with any vaccine, as this may affect its results.However, immediately after the evaluation of the sample results can be carried out any vaccination.
Mantoux test should be placed at least 4 weeks after vaccination with inactivated (killed) vaccines: influenza, tetanus, diphtheria, etc. and 6 weeks after vaccination with live vaccines:. Measles, rubella, mumps and other