Tuberculin test or Mantoux reaction: the norm for children and useful information for parents. Dr. Komarovsky about the Mantoux Mantoux test for a child at 1 year old contraindications

The Mantoux reaction is important preventive measure, which reveals the presence of a tubercle bacillus in the body. Tuberculin test for a child is carried out in without fail regularly from the first year. This is a kind allergic test which is injected subcutaneously. Do not confuse it with anti-tuberculosis vaccinations such as BCG and BCG M. The substance - tuberculin, which contains Mantoux, is an allergen, not an antigen.

The test has its indications and contraindications. There are quite a lot of prohibitions for all ages and they must be taken into account, since neglect can lead to serious consequences.

Contraindications in children younger age are quite difficult to detect. That is why parents should clearly know when the test will be carried out and warn in time medical staff about the presence of prohibitions or complaints of the child.

Injected tuberculin consists of complex components that can be quite difficult to tolerate by the human body. Therefore, even if no prohibitions were identified before the primary Mantoux, the patient's condition must be carefully monitored in order to provide immediate medical assistance if necessary.

The drug consists of the following components:

• phosphate solution salts;
• sodium chloride;
• phenol;
• preservative Twin-80.

Intolerance by the patient's body to any of the listed components can lead to serious complications.

Prohibitions

There is the following series of prohibitions on the annual Mantoux test:

Coughing fits and runny nose

With a cough or runny nose of any nature (allergic reaction, trauma respiratory organs or sharp respiratory infections) this test is contraindicated. Gotta wait full recovery sick. Otherwise, the Mantoux reaction may not show accurate results.

Elevated temperature

Such a preventive measure is contraindicated even with a minimal rise in body temperature. This is due to the fact that its slight increase indicates the presence of an inflammatory or infectious process in the body. The immune system begins to fight emerging diseases, and an additional load in the form of Mantoux can only aggravate the situation.

The test can be performed no earlier than fifteen days after complete recovery. It is also necessary to eliminate the risk of relapse.

Diarrhea

Diarrhea is evidence of intoxication. Wait before inserting full recovery, at least within a week after the cessation of loose stools.

Pathologies of a neurological nature

For neurological disorders such as epileptic seizures, it is necessary to carry out a number of mandatory studies. Only after the results of the examination and confirmation that the sample does not harm the patient's condition, can the reaction be carried out. The procedure is performed under the strict supervision of a specialist.

Skin diseases

With any skin pathologies, the reaction will not give accurate results, moreover, carried out during the height of the disease, can further aggravate the patient's condition.

Allergic reaction

Allergy, which made itself felt a few days before the test, is a complete contraindication to its implementation. The Mantoux reaction in this case will not only not show the necessary results, but will also cause significant harm to the patient's health.

Temporary contraindications

Mantoux cannot be carried out on the same day as vaccination and revaccination. Vaccinations activate the immune system to fight TB. If you vaccinate and test at the same time, it is impossible to predict the reaction of the body, and the Mantoux result may be false.

Mantoux must be done before vaccination or revaccination, while it will not affect the vaccinations themselves. Injections can be made immediately after receiving information about the sample. If vaccinations are scheduled according to the medical calendar before the test, then between vaccination and revaccination, you must wait at least thirty days. If live tuberculosis microbacteria are present in the vaccine, this diagnostic method can be carried out no earlier than a month and a half later.

Also, temporary contraindications include quarantine at school or preschool. This is due to the fact that the body can be weakened due to the constant struggle with an infectious disease, as a result of which quarantine was announced. Mantu can be put only a month after its completion. Otherwise, an incorrect result may appear.

It is possible to violate temporary contraindications only with the permission of the attending physician, as well as if infection with a bacillus is suspected.

Side effects

If the tuberculin test was done without taking into account contraindications, or the body does not perceive any components of tuberculin, the following side effects may occur:

1. Increase in body temperature.
2. Strong chill.
3. Violations of the functioning of the gastrointestinal tract.
4. Dizziness.
5. Acute allergic reaction.

If you follow all the contraindications and recommendations, the tuberculin test is painless and without any serious consequences. If the reaction caused negative complications, then this must be reported. medical worker before the next test.

Mantoux reaction without contraindications

After the reaction, a small seal will appear on the skin. The speck should be slightly swollen. On the third day, the specialist measures the sample, but does not take into account the size of the redness that appeared around the seal. A negative result is detected in cases where the size of the swelling is less than one millimeter. This suggests that the patient's body did not react to the injected substance tuberculin, which means that there is no presence of microbes that cause tuberculosis.

Children with a weakened immune system also show a negative reaction. This indicates that the child has been infected with a tubercle bacillus, and less than three months have passed since then. In order for all test indicators to be reliable, it must be performed in compliance with all rules and recommendations.

If the size of the injection in children is less than four millimeters, this indicator is considered doubtful. A positive result occurs when the seal has a value of five to sixteen millimeters. This reaction suggests that the immune system can fight pathogenic bacteria. If the result is very strong, it is called hyperergic. In this case, the Mantoux test can have a size of about seventeen millimeters. This sign indicates that the patient is infected with a tubercle bacillus. If a small purulent formation appears at the injection site, this may indicate a viral infection.

Immunity to Koch's wand is developed in case of positive result tuberculin test. The swelling will be pinkish in color without distinct lines. The Mantoux test passes quickly, and no spots form at the injection site.

There is such a thing as the Mantoux turn. It means that the swelling from the injection has grown, in comparison with the previous result. This is a sign of the presence of pathogenic microbes in the body.

If you test frequently (more than once a year), the sensitivity to Mantoux increases. In this case, the injection site increases, and this is considered a false result. This phenomenon is called the "booster effect". If a medical worker has doubts about the correctness of the indicators, he refers the patient to a phthisiatrician who will conduct a complete diagnosis.

Mantoux reaction - a technique for analyzing the severity of immunity to a pathogen serious illness- tuberculosis. Hence other names: tuberculin diagnostics, tuberculin test. diagnostic test is held annually in kindergartens, clinics and schools.

For many parents, the study raises many questions. Passions are fueled by stories about the optionality of diagnostics, the fashion for refusing to vaccinate. The material will help parents understand why it is important to conduct a tuberculin test, whether there are contraindications. Learn more about what is the norm and pathology in the Mantoux reaction.

general information

A special test confirms or refutes the presence of tuberculosis bacillus in the body. Tuberculin, administered intradermally, indicates the presence of a causative agent of a serious illness. An analysis of the reaction to the drug gives an answer: is there a Koch stick in the body or not.

The essence of the method:

• extract based on Mycobacterium tuberculosis, containing auxiliary components, is administered intradermally;
• after a diagnostic Pirquet test, a papule appears at the injection site - a compacted area of ​​\u200b\u200bthe skin, redness appears;
• in some children, the reaction is weak, the papule is practically absent or hardly noticeable. In some cases, the red swollen spot grows to 15–17 mm or more;
• 72 hours after the tuberculin test, the doctor monitors the reaction of the body. The doctor examines the injection site, checks the thickness of the epidermis at the injection site, and measures the size of the papule with a transparent ruler. In the absence of compaction, the diameter of the reddened area matters;
• according to the results of the diagnostic test, the doctor records the size of the papule, the nature of the reaction in the card of the young patient. In case of violation of the norms, the doctor writes out a referral for examination to an anti-tuberculosis dispensary.

Why is a test necessary?

In countries where tuberculosis is one of the national problems, tuberculin testing is mandatory. The technique allows you to effectively control dangerous infection track the spread of the disease.

The Pirke reaction is needed to solve certain problems:

• active detection of primary infected patients;
• diagnosis of tuberculosis in patients who have Koch's bacillus, but not visible signs serious illness;
• confirmation of the diagnosis in case of suspected tuberculosis;
• identification of patients who were infected a year ago or more. Marked enlarged papule, active redness;
• selection of children aged 6–7, adolescents aged 14–15 for mandatory revaccination against dangerous disease- tuberculosis.

Mantoux reaction: vaccination or not

Many parents call the tuberculin test a vaccine, but in fact it is not:

• Vaccination produces immunity against a specific pathogen. After vaccination, the child receives protection for a certain period of time. Revaccination is often required to maintain specific immunity for a longer period of time;
• Mantoux reaction is a diagnostic test, with the help of which the reaction of the body to the lysate from Mycobacterium tuberculosis is visible. The more active the redness, the larger the size of the papule, the higher the probability of finding a tubercle bacillus in the body.

Norm and deviations

The nature of the reaction during the diagnostic test:

• negative. There is no infiltration, the injection site is indicated by a dot up to 1 mm;
• doubtful. With this form, the papule grows from 2 to 4 mm. The second option - with redness of any size, there is no seal;
• positive Mantu. The injection site turns into a papule with a diameter of 5 mm or more. Manifestations can be weakly positive - the papule reaches 9 mm, of medium intensity - 14 mm, well pronounced - the diameter is from 15 to 16 mm;
• strongly pronounced- in this case, the infiltrate reaches 17 mm or more;
• dangerous, vesiculo-necrotic. Dead areas appear at the injection site, daughter screenings, pustules appear nearby, nearby lymph nodes increase.

When the child is sent for examination to the TB dispensary

You should not panic if you have a doubtful or mild (moderate) reaction to tuberculin. When evaluating the results, doctors take into account the time elapsed since the last BCG vaccination.

Landmarks:

• year after BCG vaccination. Permissible values ​​are from 5 to 15 mm. Seal, redness - manifestations of post-vaccination immunity;
• two years after vaccination. The infiltrate during the Mantoux reaction should be smaller or remain at the same level. With an increase in papular formation by more than 5 mm, severe redness requires an additional examination to exclude infection with Koch's wand;
• three to five years after introduction BCG vaccines. After this period, the maximum allowable papule size is no more than 8 mm, optimally up to 5 mm. At good immunity many children have a negative reaction: after a couple of days, only a dot is visible at the injection site. Swelling, redness is practically absent. With an increase in infiltrate, the doctor will write out a referral for examination to a tuberculosis dispensary.

What factors affect the final result

The following factors often distort the response to the introduction of tuberculin:

• hemodialysis;
• real immunodeficiency;
• chemotherapy of various neoplasms;
• errors in the diagnostic test;
• use of low-quality tools;
• violation of the parameters of transportation / storage of tuberculin.

You can't panic when positive reaction Mantu. Doctors never diagnose TB only on the basis of a tuberculin test. Wanted additional research: sputum collection, radiography chest, clarification of the timing of the BCG vaccination.

Indications

The Mantoux test is mandatory for all children aged 1 to 17 years. It is important to consider absolute and relative contraindications.

Doctors recommend tuberculin testing for all children who have no restrictions on the test. The Pirquet reaction is the most reliable method, which reveals the body's reaction to the presence of tubercle bacillus. For this reason, for a hundred years the drug (tuberculin) has not undergone fundamental changes.

Contraindications

Tuberculin is safe for children: there are no living microorganisms, the minimum dosage, no effect on the immune system. Despite this fact, there are limitations to the study.

Important point! The child has recently had ARVI, a cold, another infection? Has the group or class been quarantined due to a contagious disease? A diagnostic test for the detection of tuberculosis pathogens is allowed after a month after the removal of quarantine / disappearance of all clinical signs pathology.

Pay attention to contraindications:

• allergic reactions in children, especially 4–6 years old, with a weak immune system;
• epilepsy;
• infectious, somatic diseases (acute plus chronic form) with pronounced clinical symptoms;
• dermatological diseases;
• age up to 1 year (distorted reactions, inaccurate / unreliable answer).

All parents should know the list: setting the Pirquet test at the wrong time, in the presence of restrictions, often gives the wrong result. Parents with a child are forced to visit a TB dispensary with a certain frequency, to conduct repeated examinations, and the reaction, in fact, is a false positive. For example, not everyone knows that allergies + weak immunity in children, the size of the papule on the arm is often increased.

A page is written about massage for dacryocystitis in newborns.

At the address, read about the rules for the use and dosage of Orvirem for children.

Vaccinations and Mantoux: how to combine

Parents should know certain rules, control whether doctors observe the interval between vaccination and tuberculin test. A certain interval is needed for the return of immunity sufficient to deal with microdoses of inactivated and live vaccines. Intervals are needed to exclude the mutual influence of two stimuli.

Basic Rules:

• it is forbidden to test Pirquet and vaccinate. With a high load on the immune system, false positive reactions are often noted;
• after evaluating the results of the Mantoux reaction (in the absence of indications for referral to a tuberculosis dispensary), it is allowed to be vaccinated the next day;
• Is it time for routine vaccinations? After vaccination against tetanus, influenza, diphtheria using killed vaccines, the interval until the next Pirquet test is 4 weeks or more;
• after vaccination with live vaccines (rubella, mumps, measles, OPV), wait with a tuberculin test for 6 weeks or more.

How is the diagnosis

Testing for tuberculosis takes a little time, does not require special preparation from children and parents:

• tuberculin is injected with a special syringe into a certain area - the middle third of the forearm, from the inside;
• the needle is inserted intradermally to a minimum depth;
• dose volume for intradermal administration - 0.1 ml, which is 2 TU (tuberculous units);
• after an injection, a tubercle appears under the skin - a papule. The site of the test turns a little red, the compacted area slightly rises above the skin.

What can and cannot be done after the test

The child and parents must follow certain rules:

• Before testing, do not wet the area where the sample was placed. Did the child forget about the warning, accidentally wet his hand? Be sure to tell your doctor about this, especially if the spot has increased dramatically after the incident;
• it is forbidden to rub, comb, scratch the infiltrate;
• it is impossible to heat, smear with brilliant green or hydrogen peroxide papule and hyperemic (reddened) area;
• it is forbidden to seal the injection area with adhesive tape, bandage;
• it is important to wear clothes made from natural fabrics that do not irritate the skin of the forearm. Be sure to wear a flannel, knitted or cotton blouse under a wool sweater;
• you can not press, often touch the papule and hyperemic area.

Do not be afraid to perform a Pirque test in a child: the drug is safe for a growing organism. Annual tests show a complete picture of the presence of tuberculosis bacillus, reflect the dynamics, and speak of the strength of immunity. In case of deviations from the norm, follow the instructions of the doctor exactly, be sure to conduct an additional examination in a specialized institution.

Timely visit to the TB dispensary for diagnosis dangerous disease will warn severe consequences. Remember: it is easier to identify and prevent the development of pathology than to treat the complications that patients face with an advanced form of tuberculosis.

More interesting information about Mantoux in a child in the following video:

• How does the body react to the Mantoux test?

Many parents are wary when they find out that the child needs to do the Mantoux reaction, there are contraindications to this procedure. Diagnosis of tuberculosis is very important, it is done in order to identify the disease. As for vaccinations, they are given to the child in different ages.

They are often given to newborns. Vaccination against tuberculosis is important, it is done on the fourth day after the birth of the baby, and children aged 7 and 14 also need an injection. Before the last vaccination, a test should be carried out, according to its results, it will be seen whether there is an infection in the body and whether Mantoux needs to be done.

During the injection, a special substance is introduced - tuberculin: it is necessary to detect the disease.

Tuberculin suggested using a famous French doctor. Today, this diagnostic method is one of the most common. The Mantoux reaction is a preventive method of influencing the body; it cannot be called a vaccination. Some parents believe that during the diagnosis, the child may be infected with tuberculosis. As practice shows, such accusations are unjustified. The substance is administered for the purpose of detecting a disease. When vaccination or diagnosis is carried out on time, tuberculosis is easier to detect. Treatment will be scheduled in a timely manner.

After a small dose of the substance is injected into the wrist area, a corresponding reaction appears on the skin, as a rule, it looks like a thickening of the skin. Compaction is explained by the fact that T-lymphocytes gather near the injection site, they are responsible for the destruction of viruses. If there are many T-lymphocytes, the area around the injection turns red strongly. The Mantoux reaction is negative if the body does not know mycobacterium tuberculosis infection. In this case, the area of ​​redness has small size. If this place has become large, it can be concluded that there are mycobacteria, the Mantoux reaction is considered positive. Judging by the Mantoux test, it is impossible to draw an unambiguous conclusion about the presence of tuberculosis. It is necessary to conduct many other tests, thanks to which the picture of the disease will be visible.

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Contraindications for diagnosis

It is important to remember that injections are not for everyone. There are indications and contraindications for the Mantoux reaction. If the child has skin diseases, allergic rash, Mantu can not be done. In epileptic diseases, it is strictly forbidden to carry out this diagnosis. You can not do a test if the child is currently suffering from any disease or after recovery has not passed a month. The rules of the procedure must be followed. No other vaccinations are given a month before the injection. It is strictly forbidden to do another vaccination on the day the injection was given. Contraindications to Mantu should be known without fail.

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About the Mantoux test: revealing the results

After the doctor has performed the procedure, the patient has a small seal on the skin, it looks slightly swollen. On the third day, the doctor takes measurements, he does not take into account the redness that appeared near the seal. The size of the redness may vary. A negative Mantoux reaction occurs when the compaction is less than 1 mm. Thus, the body does not send signals to the injected tuberculin, which indicates that there were no such bacteria before. Also, a negative manifestation occurs in children who have weak immunity. What else does this Mantoux reaction indicate? Perhaps it arose if the child had tuberculosis and less than three months have passed since the illness. To obtain reliable results, it is necessary to carry out the procedure in accordance with the rules and established standards.

The reaction may be questionable, in this case the size of the seal is less than 4 mm. We can talk about positive when the amount of vaccination is 5-16 mm. This means that the body has immunity to fight tuberculosis. If a positive reaction is expressed excessively, it is called hyperergic: the seal becomes very large, its size fluctuates within 17 mm. This suggests that the child is sick with tuberculosis, there may be small abscesses at the site of compaction. A hyperergic reaction may occur if the child has had a viral colds.

Post-vaccination immunity may appear after a positive Mantoux reaction in a child, in which case the redness has a pinkish tint without obvious outlines. Such redness quickly disappears, after it there is no age spots. What is a Mantoux reaction turn? This concept implies an increase in the size of the seal compared to the previous procedure. The doctor has the ability to diagnose an infection in a child. In medicine, there is the concept of "booster effect". If the test is carried out more than once a year, sensitivity to tuberculin increases, the diameter of the seal becomes relatively large, in this case false positive reaction. If the doctor doubts the accuracy of the result, the child is referred to a phthisiatrician, and additional examinations are carried out.

The Mantoux test is immunological test, which allows you to determine the presence of tuberculosis bacilli in the body. It is carried out regularly for children, since their immune system is not yet perfect enough and cannot fully repel the attacks of various pathogenic bacteria. Adults, on the other hand, should only be regularly tested for tuberculosis if they work in a childcare facility, hospital, or food industry. In other cases, such a procedure is mandatory only when there is a suspicion of the development of this lung disease. Vaccination against tuberculosis is carried out in the first few days of a child's life. The body forms the maximum resistance to the disease by the age of 1 year. Starting from this age, a Mantoux test is carried out. Many mistakenly believe this procedure harmless and without contraindications, which in reality is not at all the case. There are a lot of prohibitions for her, and all of them must certainly be taken into account. Contraindications apply to all age categories.

The composition of the preparation for the Mantoux test

The name of the drug used to detect the presence of tubercle bacilli in the body is tuberculin. Its composition is quite complex, consisting of several components. Tuberculin contains:

• phosphate solution salts;
• sodium chloride;
• phenol;
• preservative Twin-80.

All these substances can be poorly tolerated by the body, and therefore, when the procedure is performed for the first time, the person's condition should be observed especially carefully so that in case of an allergic reaction, help is provided in a timely manner.

Temporary restriction on the Mantoux test

In some cases, the procedure falls under a temporary ban. The first limitation in carrying out this method of diagnosis is the passage of routine vaccinations. In this case, due to a strong overload of the body, it is impossible to obtain a reliable result. At least 45 days must elapse between the last vaccination and the test. The second limitation is quarantine. If a quarantine is declared in the preschool institution that the child attends or the school, the Mantoux test should be postponed for 1 month. This is necessary because of the high probability that the child is weakened by constant resistance to pathogens, for which quarantine is declared, and the Mantoux test in such a situation can give a completely wrong result.

Exceptions in such situations can be made only on the recommendation of a doctor and only if there is a very high probability that the child has been infected with tuberculosis.

Contraindications to the Mantoux test

Contraindications to the procedure should be taken into account without fail. If they are ignored, there is a risk of severe consequences for the body. Adults themselves can notify the doctor that they have certain conditions that prohibit the diagnosis. Children, especially younger ones, are unlikely to be able to notify the nurse performing the procedure on their own. In this case, if she herself does not see obvious contraindications, the injection will be made and, most likely, will lead to complications. Therefore, parents should know exactly when the procedure will be performed, and, if necessary, inform the doctors that their child cannot be given a Mantoux test at the moment. The prohibitions for Mantoux are:

• elevated body temperature - the procedure is contraindicated even if the increase is very slight, starting from 37.1. This state of the body signals the presence of inflammation or the onset viral disease, because of which any additional load on the patient's body is unacceptable. After complete recovery, the Mantoux test can be placed no earlier than 15 days later;
• cough, whatever nature it may be - an allergy, viral infection, injury respiratory tract, - categorically prohibits the Mantoux test until the patient is completely recovered. During this period, the additional load is harmful to the body, and the Mantoux test itself will not give an accurate result;
• a runny nose is also a strict contraindication, like a cough, and the reason for refusing the test is the same;
• skin diseases - if this contraindication is not taken into account, not only will an incorrect result of the Mantoux test be obtained, but also a serious progression of the disease will be provoked;
• allergy - exacerbation chronic allergies or an acute allergy that occurred 2-3 days before the procedure is a strict contraindication. This is due to the fact that in such a situation, an increase in allergies is possible, which will be a response to the administered drug. With an allergy, the Mantoux test will give an incorrect result and seriously harm the patient's health;
• diarrhea - it does not occur when normal condition organism and always indicates intoxication. Given this, the Mantoux test should be postponed for at least 1 week from the moment the diarrhea stops. This is required in order for the patient's body to fully recover;
• neurological disorders - all such disorders require a special examination before the Mantoux test, and only if the procedure cannot aggravate the patient's condition, it is carried out under special medical supervision.

It is forbidden to ignore these contraindications to the procedure.

What side effects can occur after Mantoux

Even in the absence of contraindications, the Mantoux test cannot always be easily tolerated, and sometimes it causes a number of side effects. Sometimes the following conditions occur after the procedure:

• temperature rise;
• chills;
• indigestion;
• dizziness;
• acute allergy.

In the event that all contraindications are taken into account, the procedure is tolerated quite easily and rarely causes unpleasant phenomena. If side effect Mantoux is very pronounced, during the second procedure, you should inform the doctor and decide together with him whether it is worth re-taking the Mantoux test.

The Mantoux test has nothing to do with vaccination. This is a kind of skin allergy test, which has specific patterns depending on whether the body is infected with Mycobacterium tuberculosis or not.

During the test, Mantoux is administered tuberculin . Tuberculin was prepared and used by Robert Koch back in 1890. Koch, however, thought that he would be able to cure tuberculosis with this very tuberculin, but it didn’t work out ...

Tuberculin is a mixture of organic matter varying degrees complexity derived from mycobacteria.

There are two preparations of tuberculin.

1. Koch's old tuberculin (alttuberculin, ATK) is an extract from mycobacteria neutralized by heating. The main disadvantage of old tuberculin is a large number of impurities, so it is not always possible to understand what, in fact, the body reacts to: to the antigens of mycobacteria or to the remains of the nutrient medium in which the mycobacteria were grown.

2. Purified standard tuberculin(Purified Prolein Derivative, PPD) is a preparation purified from protein impurities in the nutrient medium.

Currently, in most countries and in most medical institutions, exclusively purified tuberculin is used.

For mass tuberculin diagnostics, a standard dilution of the drug is used: 0.1 ml of the solution contains 2 TU (tuberculin units). 2 TU is the usual dose that is administered intradermally, and this administration is called Mantoux test .

Intradermal administration of tuberculin leads to a local allergic reaction. The severity of the reaction depends on whether the body has "experience of communication" with a tubercle bacillus or not. If contact with mycobacterium has taken place, then the result of this contact will be the formation of special lymphocytes, and it is these lymphocytes that will cause local allergic reaction with intradermal administration of tuberculin.

Tuberculin diagnosis is:

• mass - conducted to all children in countries with high level incidence of tuberculosis;
• individual - is carried out for individual patients when indicated.

The main tasks of tuberculin diagnostics:

• timely detection of tuberculosis in children and adolescents;
• identification of children subject to vaccination and revaccination.

The mass Mantoux test for children vaccinated with BCG vaccine is carried out annually, starting from the age of 12 months. For children not vaccinated with BCG, the Mantoux test is performed twice a year. Also, twice a year, it is recommended to conduct a Mantoux test for children who have not experienced local reaction after BCG vaccination.

The Mantoux test is performed BEFORE preventive vaccinations.

If any vaccination has been carried out, then the Mantoux test is carried out no earlier than 1 month after it.

If blood products (immunoglobulins, etc.) were used, then the Mantoux test is performed no earlier than 2 weeks later.

The Mantoux test is carried out in the middle third of the inner surface of the forearm.

Note!

After intradermal administration of tuberculin this place it is forbidden :

• to rub;
• scratch;
• treat with disinfectant solutions;
• stick with adhesive tape;
• bandage.

Bathe (wet, dive, wash) after the Mantoux test can .

Reaction accounting performed within 72 hours. The reaction to tuberculin is possible in two ways:

• skin redness - hyperemia ;
• education papules . A papule is a rounded area of ​​increased density (infiltrate) that rises above the skin.

Accounting for the Mantoux test is a measurement of the size of the papule and an assessment of the severity of hyperemia.

The measurement is carried out in the direction transverse to the axis of the hand, in good lighting conditions, with a transparent ruler. The result is indicated in mm.

Note: it is not the size of the redness that is measured, but the size of the seal!

If there is no papule, indicate the size of hyperemia.

Reaction options:

• negative- there are no changes on the skin;
• dubious- there is redness of any size without a papule or the size of the papule does not exceed 2-4 mm;
• positive mild- papule diameter 5-9 mm;
• positive average intensity- papule diameter 10-14 mm;
• positive pronounced- papule diameter 15-16 mm;
• excessive (hyperergic)- the diameter of the papule exceeds 17 mm or there are pronounced signs inflammation (reaction of lymph nodes, skin ulceration, etc.).

Tuberculin test turn is a transition backlash Mantoux positive (not associated with previous vaccination) or an increase in the diameter of the papule compared to the result of the previous test by 6 mm or more.

Contraindications for tuberculin diagnostics:

• skin diseases;
• acute infectious diseases;
• chronic diseases in the period of exacerbation;
• allergic conditions, rheumatism, bronchial asthma;
• quarantine in the children's team.

Basic principles for interpreting the results of the Mantoux test:

• a negative Mantoux test indicates that there are no lymphocytes in the body that have experience in communicating with a tuberculosis bacterium: there is no infection, there is no reaction to BCG vaccination;
• a doubtful sample is equated to a negative one;
• a positive test can be both a consequence of BCG vaccination and a sign of infection;
• The signs of infection according to the results of tuberculin diagnostics include:

The turn of the tuberculin test;

Hyperergic reaction;

Persistent (more than 4 years) persistent reaction with a papule of 12 or more mm;

Gradual, over several years, increased sensitivity to tuberculin with the formation of an infiltrate of 12 mm or more.

The results of the Mantoux test may be influenced by:

• mode of transportation and storage of tuberculin;
• technical errors in the formulation of the sample;
• technical errors in accounting for the reaction;
• the presence of chronic diseases;
• tendency to allergic reactions;
• individual skin sensitivity;
• skin contact with others allergens (clothing, detergents etc.);
• ambient temperature and humidity;
• phase of the menstrual cycle;
• background radiation and other environmental factors;
• reception medicines etc.

Note!

The Mantoux test is an indicative diagnostic test.

The Mantoux test, without taking into account many other factors, is not a reason for the diagnosis of tuberculosis and any treatment.

The Mantoux test is Additional Information for consideration for the doctor.

Tuberculin preparations:

Tuberculosis allergen, purified liquid standard dilution(purified tuberculin standard dilution) — (CJSC Biolek, Ukraine, CJSC Immunoteks, Russia).

Purified lyophilized tuberculin (Sanofi Pasteur, France).

Charles Mantoux is a French scientist who, in 1908, proposed the intradermal administration of tuberculin for diagnostic purposes.