What should be the mantoux reaction in an adult. Do they make manta an adult

Timely diagnosis of tuberculosis plays an important role in the treatment of this disease. To confirm the fact of the absence or presence of a disease, you need to know what the Mantoux reaction looks like normally.

Do they make Manta an adult

Mantoux is rarely done to adults, because in 90% of cases the result is positive (almost the entire adult population of the country is infected with Mycobacterium tuberculosis). If there are predisposing factors (decreased immune defense, living in cold and damp rooms, unbalanced nutrition, etc.), the disease begins to develop.

The following diagnostic measures help to establish the fact of the presence of the disease in an adult:

• blood test (general, biochemical);
• fluorography (radiography);
• CT scan;
• bacteriological analysis of sputum.

How to determine the result yourself

The result is determined by the size of the Mantoux 3 days after the subcutaneous injection of the drug. Measurements are carried out with a transparent ruler in sufficient light. Do it like this:

1. Examine the injection site for redness and swelling.
2. Carefully feel the skin at the injection site of tuberculin and determine the diameter of the papule ("buttons", "plaques"). During measurements, the ruler is held perpendicular to the radius.
3. The allowable size of the Mantoux is determined and compared with the result obtained.

Doctors advise to determine the diameter of the seal or (if it is absent) hyperemia near the injection site. If you can’t do it yourself, you need to wait for the verdict of the health worker.

What can affect the results of the test

The diagnostic event is accurate, but not 100%. Various factors can influence the Mantoux reaction in adults and children. The most common are:

Other reasons why the Mantoux test in adults and children differs from the permissible one are recent infections, diseases with a chronic course, and other disorders of systems and organs.

What size Mantoux is considered normal

To understand how many centimeters (cm) Mantoux should be normal, many factors should be taken into account: age, body condition, living conditions and the time that has passed after the BCG injection.

Possible reactions:

1. 12 months after vaccination, a normal papule is 5 to 15 mm in size. The reason for a visit to the doctor is considered to be a seal larger than 1.7 cm in diameter.
2. After 2 years, the size should be the same for Mantoux. If the papule has increased by 2-6 mm or more, this may indicate an infection (it is worth making an appointment with a phthisiatrician). Most often, the "button" decreases every year after vaccination.
3. After a sufficient amount of time after BCG (3-5 years), the “button” decreases. The normal reaction to Mantoux in this case is 5-8 mm. If the papule remains the same diameter or increases, it is assumed that the patient has tuberculosis. In this case, it is necessary to consult a phthisiatrician and undergo a complete examination.

For adults, the norm is 0-4 mm. Sometimes the result differs in a big way, but this is not a sign of the presence of tuberculosis.

You can find out how many centimeters Mantoux should be for chronic diseases, dysbacteriosis, allergies and other pathologies from your doctor.

The size of the papule in childhood changes over time:

• 1-2 years - 5-11 mm;
• 3-4 years - up to 8 mm;
• 5-7 years - 0-4 mm.

What does a normal reaction look like?

Some time after the administration of the drug, a focus of inflammation appears - a papule. At the injection site, the skin turns red and becomes dense. Normally, Mantoux in adults and children does not exceed 11 mm. In this case, the redness can be of any size and is not a cause for concern.

Classification of results

To obtain a reliable result, within 3 days after the injection, you can not act on the papule (wash, comb, cover with a bandage or plaster, treat with brilliant green or iodine).

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To get information about the state of health, you need to find out what the reaction to Mantoux may be in a child and an adult.

Negative result

If the papule is 0-4 mm in diameter, this means that the person has never encountered Koch's wand or managed to get sick and recover. When evaluating the results, doctors use special medical tables indicating the age category and the permissible seal diameter. It is impossible to be guided only by the results of the table. The Mantoux reaction in normal adults can exceed 11 mm in the presence of certain factors (systemic diseases, increased activity of the immune system, etc.).

Doubtful reaction

If there is redness up to 4 mm in diameter, but no induration, the sample is considered doubtful. Additional diagnostic measures in such cases are rarely carried out.

Positive test

To talk about a positive test, the patient must have a Mantoux reaction with a papule. This reaction can be mild (the size of the “button” is up to 10 millimeters), medium (up to 14) and pronounced (from 15 to 18).

A positive test may indicate the onset of tuberculosis. Therefore, a person is registered even if further examination does not confirm the presence of the disease. After 1 year, tuberculin is introduced again. In case of a negative result, the person is removed from the register and goes under the supervision of a pediatrician.

hyperergic reaction

If the seal is more than 1.7 cm in diameter, the reaction is hyperergic. An increase in papule may be accompanied by swelling of the lymph nodes, the appearance of acne with purulent contents, and even tissue necrosis.

False positive result

Sometimes the test is positive, despite the absence of infectious agents in the body. This can happen for various reasons:

• recent vaccination (including BCG);
• infection with another group of mycobacteria;
• hypersensitivity to the active ingredient of the drug;
• recent infections.

The Mantoux reaction, the dimensions of which exceed the allowable values, is considered positive until the examination shows the opposite.

False negative reaction

All infants are vaccinated against tuberculosis, which contributes to the formation of immunity. Therefore, a false negative reaction (one in which the body cannot respond to the vaccine) is rare. This occurs when conducting a test in children under 1 year old, with violations in the work of immunity (including with AIDS) and previously transferred tuberculosis.

You can distinguish a negative reaction from a false negative if you enter a large amount of tuberculin. In the first case, an allergy occurs, in the second - no (the body stops responding to this substance). If it gives a false negative result, the patient is sent to the doctor for a full examination and determination of the cause of such a reaction.

Turn

A turn is a spontaneous change from a negative result to a positive or sharp increase in compaction (compared to the previous year). Many are wondering what size Mantoux should be in this case. There are no clear restrictions, but the reason for a visit to the dispensary is an increase in the “button” by more than 6 mm.

What to do next

If the seal exceeds the normal size, the patient is sent for examination to a phthisiatrician. With a Mantoux diameter of 10 mm or more and the absence of other confirmation of the diagnosis, prophylactic treatment, including medication, may be prescribed. It is impossible to agree to such therapy, because potent drugs can cause side effects and worsen the state of health. If the patient doubts the actions of the doctor, he should find out how much the Mantoux reaction to tuberculosis is normal, and visit another specialist.

A method for analyzing the reaction of the human body to the introduction of the causative agent of tuberculosis into it is the Mantoux test or the tuberculin test. It is named after the French doctor who first proposed the subcutaneous administration of tuberculin. What can be learned from such a test? It shows if the child has tuberculosis.

Mantoux test - nothing to fear

To date, the following topics for parents are burning: Mantoux test, evaluation of the result in children. Photos that are found in open sources often amaze the imagination and create a wide scope for parental fears. After looking at them and reading information on the Internet, many parents simply refuse to give this vaccine to their children. Although in fact the Mantoux reaction does not apply to vaccinations. With its help, you can find out if there is a disease in the body and at what stage the disease is, if the diagnosis is still confirmed. The main task of vaccination is to identify the early stages of the disease. If the evaluation of the result of the Mantoux test in children is negative, then BCG is put.

The very first Mantoux vaccination is done in a one-year return. Up to a year, the reaction is not detected for reasons of age-related development of the baby's body.
have very sensitive skin. The result may turn out to be unreliable, but it is determined according to some standards that indicate how the Mantoux vaccination should look like. At 4 months, it is also impractical to do it. An important role in the reaction of the test is played by a balanced diet of the child. Therefore, you should carefully monitor his diet.

Mantoux vaccination is done every year, once. For 14 years, children need to undergo this test strictly according to the schedule, because only in dynamics can you see the presence of the disease or identify a predisposition to it.

First time

The first test is given to a child at the age of 12 months. Scientists have proven that previously such a procedure as the Mantoux test was meaningless. The evaluation of the result in children of 1 year old is informative, but in babies who have not reached this age, the reaction is often false negative.

However, many doctors argue that if the child was not vaccinated against tuberculosis according to the calendar - in the first days after the birthday, then the test should be given twice, starting from the age of six months.

What can affect the "button"?

They vaccinate Mantoux in the arm, on its inner side, between the elbow and wrist. In addition to the fact that Mantu cannot be scratched and wet for three days, it is also highly recommended not to stick it with a plaster, rub it hard, pinch it with things, or cause any other irritation on the skin. If you do not follow these simple rules, a false positive result may form, in which case you will have to undergo an examination.

Mantoux test: evaluation of the result in children

The photo below shows that the reaction is very pronounced. In this case, the size of the papule reaches more than 1.5 cm in diameter. How else is the result evaluated?

1. A pronounced Mantoux reaction is observed with a papule size of 15-16 mm in diameter.
2. The reaction to the sample will be of medium intensity when the diameter is 10-14 mm.
3. Weakly positive reaction - if the diameter of the seal is 5-9 mm.
4. A positive reaction is observed if the size of the papule reaches 5 mm.
5. A reaction is called doubtful if the button has a size of 2 to 4 mm. This also includes cases if the Mantoux test site has redness of any size, but there is no seal - the so-called "button".
6. Negative Mantoux test - with a seal size of 0 to 1 mm.

Parents should not panic ahead of time if, after the injection, the "button" has a suspicious size, because the result on the third day may differ from what the Mantoux vaccine should look like on the first day.

We reduce risks

During the diagnosis period, all foods that may cause an allergy should be excluded from the diet. This is primarily chocolate, oranges, tangerines and other citrus fruits.

If suddenly the child wets the Mantoux, you should wipe the skin with a soft cloth, towel or napkin, without effort. Subsequently, it is necessary to inform the doctor about this during the examination. The “button” must be carefully monitored so that the assessment of the result of the Mantoux test is reliable.

What if there is severe redness?

If after the test was delivered, the injection site turned red, then you should not panic. Three days later, the doctor will pay attention not to this sign, but to the seal - the papule.

Severe redness is not considered the result of a positive reaction and an indicator of the presence

The doctor can measure the place of redness and register the result if there is no “button” at the injection site.

We measure ourselves

If desired, parents can independently determine the result at home seventy-two hours after the injection, but some still have the question of how the negative Mantoux vaccine should look like. If, after the specified time after the injection, the resulting seal does not exceed 1 mm in diameter and redness is not observed, then the result is negative. It's okay, you can breathe a sigh of relief. A questionable result is given by a “button” that does not exceed 4 mm in size, or the appearance of only redness. Education, the size of which exceeds the norm (from 5 mm - 16 mm) is a positive answer. A positive result can also mean a hyperergic reaction, sores or pustules at the injection site, the formation of a seal larger than 17 mm.

It is better to know what the Mantoux vaccination should look like on day 3. The photo below is the norm.

If the reaction is not happy

A false-positive reaction occurs when the Mantoux "button" is handled incorrectly. In this case, the child is sent for examination together with his parents. They will take all the necessary tests, and the phthisiatrician will explain the situation. Often they also offer to donate blood - this test is called PCR (polymerase chain reaction). It is used for false positive reactions that the Mantoux test gives.

The evaluation of the result is usually carried out on the basis of the annual dynamics. The size of the papule should decrease by a few millimeters per year, and by the age of seven years in a child it should be almost invisible.

What else matters?

Do not panic if the child is sent to the TB dispensary. A positive reaction may indicate that the baby is a carrier of the stick, but at the same time it is not contagious. He can attend school, kindergarten. Such sticks are not transmitted through the blood. People around are infected only from a person with tuberculosis, by airborne droplets.

However, when the Mantoux test result is positive, the child should be observed by a phthisiatrician. But if a specialist makes an appropriate diagnosis, then the little patient will have to undergo treatment.

First of all, he will be sent for a chest x-ray and microbiological examination of sputum. In addition, all family members will also be required to be screened.

Phenol and allergies - what's the connection?

Children sometimes have Mantoux vaccination. The reason for this is individual intolerance to the components of the drug or hereditary predisposition. Often the culprit of allergies is phenol, which is part of the vaccine. This substance is toxic, but in small doses it does no harm. There are cases when a child has intolerance to phenol, then allergic reactions occur. In any case, it is necessary to consult a specialist when the Mantoux test gave an allergic reaction to the body.
Evaluation of the result after a while should not be accompanied by the following allergy symptoms:

• loss of appetite;
• rash on the skin;
• high temperature;
• weakness;
• anaphylaxis.

In this case, you can safely test the next time. But you need to remember that allergies can appear anywhere on the child's body: in the groin, under the knees, on the inside of the elbow and, of course, in the place where the Mantoux test was performed. Evaluation of the result, which entails even the slightest symptoms of an allergy in a child, forces parents to immediately consult a doctor. He will prescribe antihistamines to relieve the symptoms of the allergy. Often, side effects on Mantoux occur due to recent diseases, and may be accompanied by various ailments.

If a child has chronic infectious diseases, especially in the acute stage, an allergy to something, epilepsy or a cold, then Mantoux cannot be vaccinated. It is worth postponing this event and holding it after a month after the disappearance of all symptoms. Any vaccinations weaken the immune system, so they should be given at different times. Otherwise, the evaluation of the Mantoux test result may turn out to be false positive.

Rejection of Mantoux

By law, parents can refuse the Mantoux vaccination. She is voluntary. You can refuse by writing a statement at the clinic. This should be done with 100% certainty that the child has never had contact with a patient with tuberculosis.
The Mantoux test weakens the child's immunity, like any other vaccination. To avoid this, you can use an alternative method and donate blood from a finger. The only disadvantage of such an analysis is that it is carried out only in private clinics for a fee.

Mantoux test: evaluation of the result in adults

The photos presented above illustrate well in children. In adults, it is practically no different.

Mantoux is an immunological test that indicates the presence of a tubercle bacillus in the body.

After the introduction of the drug, which contains tuberculin, a reaction occurs. With its help, you can find out if a person is sick. At the injection site, inflammation appears, caused by blood cells responsible for immunity. Lymphocytes are attracted from the nearby blood vessels of the skin with the help of fragments of microbacteria. But not all lymphocytes are attracted, but only those that were already familiar with Koch's wand before.

If a person is infected with a bacterium, then the inflammation will be large, the result will be positive, and if the possibility of infection was earlier, but it did not happen, then the reaction will be with pronounced, but not intense irritation. Of course, from a positive reaction it follows that the plaque did not arise due to the injection itself and possible skin irritation due to it, but because a certain reaction occurred.

Operating principle

After the introduction of tuberculin, a certain allergic reaction occurs. And on the second or third day, a seal appears on the skin, where the Mantoux test was placed. The assessment of the result (how the “button” should look like) will be reliable only when all the rules for caring for the injection site are followed.

Usually it has a convex swelling that rises above the general level of the skin, often reddened and dense to the touch. The more immune cells in the human body that have encountered the tuberculosis bacillus, the more pronounced and large the seal will be.

Reaction to Mantoux in adults

In adults, the reaction to Mantoux is of three types:

• negative;
• false positive;
• positive.

A negative test is diagnosed in the case of the complete absence of a “button”, or if it has a size of up to 1 mm. This result is considered normal. With a plaque size of two to four millimeters, its redness, the result is doubtful and can be considered a false positive. If the plaque is larger than 5 mm, the reaction is positive. If the diameter of the seal at the injection site in adults is more than 21 mm, the reaction is hyperergic.

So, Mantoux vaccination should be carried out every year in order to identify negative dynamics or possible infection. For example, for three years in a row, plaque sizes were recorded within 14 mm, and for the fourth year it increased to 20 mm. It is highly likely that infection has occurred. It is the turn of the Mantoux tuberculin test that prompts the phthisiatrician to prescribe additional examinations to a potential patient.

If the Mantoux test is alarming

Evaluation of the result (the photo has already been presented above), which raises doubts, should occur objectively. After all, there is still the possibility of an allergic reaction to the Mantoux test, and recent infections or already existing intolerance to any substances may also affect. In these cases, the reaction may show a positive result, so any factor that adversely affects the Mantoux test should be reported to the doctor. Subject to all the rules, the result will be the most reliable.

Evaluation of the result: what they pay attention to

After 72 hours, you must consult a doctor, where the Mantoux test will be examined. Evaluation of the result, the photo of which is located below, suggests that there are no problems. But the entire examination begins with the injection site. In this case, three states can be set:

• hyperemia;
• infiltrate;
• no reaction.

It is very important to distinguish hyperemia from infiltration. To do this, they probe the “button”, and then a healthy area of ​​\u200b\u200bthe skin to determine the thickness of the seal. If the reaction is an infiltrate, then the density of the skin in a healthy area and at the injection site will be different. With hyperemia, the density of the skin is the same.

Next, you need to measure the plaque using a transparent millimeter ruler. Measure the transverse, relative to the axis of the hand, the size of the infiltrate and register it. It is strictly forbidden to perform these manipulations in a poorly lit room using improvised tools that replace the ruler. Only the seal size is to be measured. If only redness occurs at the injection site, and there is no papule, then it is recorded, but is not a reason to believe that a person has a positive reaction.

This is how a negative reaction to the Mantoux test looks like.

What are the patients saying?

Recently, the number of people opposed to having their children given a Mantoux test has increased. Evaluation of the result, reviews of parents about the procedure itself are quite categorical. In most cases, the negative attitude of adults against Mantoux lies in the fact that after it the children are sent to phthisiatricians. In fact, it turns out that the alarm is false, and the “button” has become inflamed for reasons completely unrelated to tuberculosis.

But it is worth remembering that it is still necessary to take tests. If you do not like the Mantoux test, there are alternative methods for determining tuberculosis cells in the human body.

• Sample technology
• Mantoux reaction and its evaluation

It should be noted right away that in adults it is usually checked only in special cases. Tuberculosis in people who have reached the age of majority is detected using fluorography, laboratory blood tests or pulmonary sputum.

Mantoux in adults is checked when an active form of tuberculosis is suspected or when contacts with patients with this disease become known. In addition, it is carried out for those adults who will have to re-administer the BCG anti-tuberculosis vaccine. If the Mantoux result is in doubt, more serious tests are already being carried out.

The Mantoux test involves injecting a drug called tuberculin into a person's skin, usually on the forearm of the left hand. It is produced on the basis of a culture of tuberculosis bacteria, but such vaccines do not contain live microorganisms, so there is no risk of contracting tuberculosis when they are administered.

Usually the drug is administered in the amount of 2 tuberculin units, at a dose of 0.1 mg, and is labeled PPD-L. For the introduction, a disposable sterile syringe with a volume of 1 ml is used, specially designed for this purpose and having a needle of a very small diameter. Each sample is strictly placed with a separate syringe, which immediately after that must be disposed of.

Any other vaccination should be done after the Mantoux reaction has been detected, since it can affect its result and distort it. In addition, during the period between the test and the fixation of the result, which lasts for three days, water should not be allowed to enter the skin area where the drug was injected. It should not be touched once again, and even more so combed, sealed with adhesive tape or smeared with antiseptics. Otherwise, it will be almost impossible to get a reliable result of the Mantoux test.

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Mantoux reaction and its evaluation

In the place where the drug was injected, T-lymphocytes, or immune bodies, that once had contact with Koch's bacillus, which is the causative agent of tuberculosis, begin to accumulate. When, after three days, there is no swelling, redness or other visible traces left at the place where the tuberculin preparation was vaccinated, the reaction is considered negative. If there is a trace, then the assessment depends on its characteristics. If a person has already had tuberculosis or is infected with Koch's bacillus, the Mantoux reaction, accordingly, occurs more violently.

The result of the sample is evaluated by measuring with a regular ruler. A slight swelling with a diameter of 0.5-1 mm also indicates that the tuberculin vaccination gave a negative result. He begins to raise doubts when its diameter reaches 3-4 mm. If a tumor with a diameter of 5 to 17 mm is formed at the injection site, then the Mantoux reaction shows a clearly positive result. The person is clearly infected with a tubercle bacillus. Well, in the case when the diameter of the tumor exceeds 21 mm, this means that he, most likely, is already beginning the process of tuberculosis. A picture is possible when the tumor has a smaller diameter, but its surface is an open wound. This is also an undoubted sign of a positive reaction.

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Possible reasons for the distortion of the result and contraindications for the sample

Do not forget that usually the size of the swollen area does not indicate either the localization of the disease in the body, or the duration of the course of the disease. It only indicates the presence of Koch's wand in it. There are a fairly large number of factors that can distort the result of the Mantoux test. It can be various allergic or chronic diseases that a person suffers from. If he has recently suffered any infectious disease, this may also affect the result of the test, usually in a positive direction. In addition, the result of the Mantoux test can be influenced by advanced age, the time of the menstrual cycle, as well as the individual characteristics of the skin, the general environmental situation in the place of residence of the person, and simply the quality of the tuberculin itself and the conditions in which the vaccination was made.

The Mantoux test can give both false positive and false negative results. Definitely contraindications for it is the presence of an acute infectious disease in a person and an exacerbation of a chronic illness. In addition, the test should not be performed on patients with skin diseases and those suffering from epileptic seizures. The quarantine associated with viral diseases also serves as an obstacle to her. Finally, a person may simply have an allergic reaction to a tuberculin drug. Therefore, swelling of the place where it was introduced does not usually give full confidence that a person has tuberculosis. This is just an excuse for more in-depth analysis and research.

Usually, Mantoux tests are done to adults in order to confirm the absence of a tuberculosis infection in their body if their work is related to mass communication or food. These are catering workers, teachers, counselors and other similar specialties.

In this case, the setting of such a test should be combined with a fluorographic study.

As a result, people with a positive reaction to the tuberculin preparation are identified and it becomes possible to determine epidemiological indicators by the degree of infection with a tubercle bacillus.

The Mantoux reaction in adults is quite rare, it is most common in children and minors. When a person has reached the age of majority, he is tested for tuberculosis using a study of pulmonary sputum, a laboratory blood test, or fluorography. But in some cases, when there is a clear suspicion of an active form of tuberculosis or when it becomes known that there has been contact with patients, Mantoux can be placed in adults. If the result of the test is called into question, then it is possible to conduct more serious analyzes.

How to put

The principle of staging for adults is not much different from the "children's" one. The sample is placed into the skin on the forearm of the left hand. A drug called tuberculin is introduced, created on the basis of a culture of tuberculous bacteria, but does not contain real microorganisms, therefore there is no possibility of a real tuberculosis infection.

An adult is injected with two tuberculin units weighing 0.1 mg using a disposable sterile syringe with a volume of 1 ml. To make the reaction as accurate as possible, a very small diameter needle is used.

Limitation

Other vaccinations should not be given when the Mantoux reaction was given, otherwise the readings may be distorted. Also, adhesive plasters should not be stuck on the area of ​​the skin where the sample was placed, and this area should not be smeared with antiseptic agents. Although the fact that the Mantoux test is afraid of water is a myth, you should still not wet it too much to avoid distorting the potential result.

Grade

The Mantoux reaction delivered in adults is evaluated three days after the vaccination. By that time, T-lymphocytes begin to accumulate in the place where the sample was injected, as well as immune bodies that previously had contact with Koch's bacillus, which provokes tuberculosis. If after this period of time there are no traces in principle, no swelling, no redness, or anything else, then the reaction is considered to be negative. If there is a trace, then it is necessary to evaluate it separately.

• If the reaction gave a very small diameter, swelling less than a millimeter, it is considered that the tuberculin inoculation gave a purely negative result.
• If the reaction gave a swelling, the size of which is up to 4 mm, then the result is doubtful, additional studies are necessary for more specific clarification.
• If the sample gave a swelling from 4 to 17 mm, then this means that the result is positive, infection with a tubercle bacillus has taken place, but still such a reaction is still the norm.
• If the tumor diameter exceeds 21 millimeters, then the reaction takes place in an enhanced format, which most likely means that the risk of developing tuberculosis is especially high. In this case, this is no longer the norm, the dimensions become too high for the normal values ​​​​of this sample.

Potential Distortions

But even a strong reaction is not yet a guarantee that an adult has a disease in the body; vaccination does not make it possible to accurately identify its localization or estimate the duration of its course. It simply helps to more accurately understand that Koch's wand is formally present in the body. But many factors can distort the course of the disease. These factors include:

• recent infectious disease;
• chronic or allergic diseases;
• advanced age;
• features of the menstrual cycle;
• individual distinctive features of the skin;
• tuberculin quality;
• the conditions under which the vaccination was given;
• ecological features of the region of human habitation.

Therefore, vaccination can give quite strong errors and even false positive / false negative results. Also, she may have contraindications that follow from the above consequences. In particular, when an adult has acute chronic diseases or chronic diseases in the acute stage, vaccination is not carried out. The test is not performed if the person suffers from epileptic seizures or skin diseases. Vaccination is not done when quarantine is carried out due to viral diseases.

In rare cases, a person may have an individual intolerance to the drug tuberculin. This is a rather unlikely phenomenon, but it still happens, then the sample is also distorted.

It turns out that any Mantoux test performed in adults is not an unambiguous indicator of the presence of a problem or, conversely, a favorable situation, but an occasion for additional deeper research aimed at identifying the true situation - and taking further action.

What's next?

To clarify the analysis, a fluorographic study is carried out further. It allows you to more accurately determine whether a person has an infection, and if it does, then at what stage it is. Based on this, certain measures are taken and appropriate treatment is prescribed.

Mantoux test: why should a child do it, is it dangerous? If there are no contraindications, the mantoux test is the best test for tuberculosis

To determine the infection of the body with tuberculous mycobacteria, a diagnostic examination is carried out in the form of a Mantoux test. This procedure should not be confused with vaccination. Mantoux is not a vaccination, it is only a provocative action to cause an allergic reaction on human skin in the form of redness at the site of injection into the skin layer of Tuberculin, a mixture of organic substances obtained from Koch bacteria, purified from proteins and nutrient substrates. in adults, it is checked for suspected communication with sick people with an open form of tuberculosis, as well as before BCG vaccination. In this case, the sample itself is only an additional study, and if the reaction is doubtful, then they resort to additional, extended blood tests, sputum, as well as a fluorographic examination of the condition of the bronchi and lungs.

The mantoux test is carried out in adults much less frequently than in children and adolescents, but the technique is standard for everyone. The technology of its implementation is as follows: below the elbow of the left arm of an adult, a substance made from a culture of tuberculosis bacteria PPD-L is injected into the skin in the amount of 2 TU (tuberculin units) is 0.1 mg of solution. In general, there are several types of tuberculin, but in Russia, standard purified tuberculin is most often used in 2 ml ampoules. The substance is absolutely harmless, does not contain a live culture and does not cause infection. The procedure is carried out with a disposable sterile insulin syringe with a very thin needle that painlessly penetrates the skin layer (in no case intramuscularly or subcutaneously). After the injection, the syringe is disinfected and subsequently disposed of.

The result of the test is recorded three days after the injection of tuberculin. Within three days, the place where the substance was injected should not get wet, combed, covered with adhesive tape or treated with antiseptics, so as not to distort the testimony.

The time of the tuberculin test is planned in such a way that no vaccinations are given a month before the test, otherwise the results of the study may not be reliable, due to individual characteristics and reactions of the body to the vaccinations. Particular attention is paid to the date of the last BCG vaccination.

All other scheduled vaccinations can only be done after the readings of the mantoux reaction have been taken and recorded.

How is the Mantoux reaction evaluated?

If a person was surrounded by tuberculosis patients, then his body should have information about this contact, it is stored in the memory of blood cells called lymphocytes. When tuberculin containing the remains of Koch bacteria is injected into human skin to carry out the mantoux reaction, the immune system immediately responds to the invasion, and T-lymphocyte cells rush to the puncture site, remembering this infection and ready to destroy it. Then there is a reaction of redness of the skin, seals near the site of penetration, and sometimes the release of infiltrate. If a person has not encountered tuberculosis, then after three days there will be no bright traces of the introduction of the substance.
The evaluation of the results itself is carried out using a ruler, since the diameter of the papule, formed or not formed as a response to the introduction of an irritant, is indicative.

Negative indicator: reaction to mantoux, the norm in adults is considered if after three days there are no traces left at the site of the test, no change in skin color, no swelling; if there is slight redness and swelling no more than 1mm.
Doubtful reaction: when the redness and the diameter of the papule (swelling) 3-4 mm.

A positive indicator: the site of the puncture and injection of tuberculin is reddened and swollen, the transverse size of the papule is from 5 to 17 mm, which indicates that the subject is infected with the Koch bacterium.

The answer, indicating that the subject was ill with tuberculosis: swelling is more than 21 mm, severe redness, sometimes the surface is an eroded purulent wound.

The Mantoux reaction is only an indicator signaling that there is Mycobacterium tuberculosis in the body, but does not determine the place of its localization and how long it stays. After a positive response to the test is detected, the person is sent for a more detailed examination to a tuberculosis dispensary.

Tuberculin test bend

This concept means the transition of a negative response to a positive one for no apparent reason, without BCG vaccination on the eve of the test. At the same time, the transition rates are very high, reaching up to 6 mm or more of an increase in swelling at the injection site, compared with previous measurements.

How to interpret the results of mantoux indicators

A negative response indicates that there are no cells in the human body that have experience in communicating with a tubercle bacillus, there is no response to BCG inoculation, therefore, a second vaccination is required. Doubtful indicators are also counted as negative indicators.

A positive response indicates that the body is infected, which had the effect of the BCG vaccine.
Evidence that the body is infected with tuberculosis:

1. the presence of a reaction turn;
2. pronounced hyperemic responses to the test with large papules;
3. over 4 years, persistence in response to the test increase in papule more than 12 mm;
4. for several years in a row, increasing irritation to tuberculin, with the formation of a papule exceeding 12 mm and an infiltrate.

Factors affecting the distortion of the result

The manifestation of a papule is evidence that there are Koch's sticks in the body, however, the indicators of the tuberculin test are distorted due to an allergy or chronic illness of a person that affects his immunity. If the subject has recently been ill with an infectious disease, the sample indicator may shift towards a positive indicator. In addition, the menstrual period in a woman, individual intolerance to the administered substance, and the age of the patient can serve as distorting factors. The environmental situation in which the subject lives can also make distorting adjustments to the ongoing research, as well as the quality of the administered tuberculin and the conditions for its storage and transportation, the technique and environment for the introduction of the testing drug (tuberculin).

In an adult, as well as in a child, a tuberculin test can cause both a false positive and a false negative response if they are sick with epilepsy, neurodermatitis, psoriasis, as well as with diseases of the gastrointestinal tract associated with helminthic invasions, chronic inflammation.

Contraindications for tuberculin test

This sample is indicative in order to make a final diagnosis, but it is convenient for population screening. To detect and prevent a mass disease of the population with tuberculosis. With its help, what kind of mood a person has for a disease caused by Koch's wand is revealed. In case of positive tests, additional examinations are prescribed.
However, it should be borne in mind that even for this test sample there are contraindications for the subject. These include:

1. acute and chronic skin diseases;
2. acute period or recent infectious diseases;
3. exacerbation of existing chronic diseases in the subject;
4. allergies, including seasonal allergies;
5. diseases of the musculoskeletal system, rheumatoid conditions, rheumatism;
6. therapeutic diseases of the lungs, bronchial asthma, bronchiectasis;
7. individual intolerance to tuberculin and substances included in its composition.

A screening examination using a mantoux shows what the epidemiological situation is among the population of both children, adolescents, and adults. These measures are aimed at maintaining a healthy environment and for early detection and prevention of the spread of a dangerous disease.