Positive mantoux test in adults. Mantoux sizes - the norm in adults

The Mantoux test is the most accessible, popular and cheap method for diagnosing tuberculosis. Tuberculin is injected under the skin - a preparation containing heat-treated, aged mycobacterium tuberculosis.

It is not able to harm the body, but the body reacts to it in a certain way.

Mantoux, also known as tuberculin test, is one of the simplest and cheapest tests that allows you to diagnose the presence of tuberculosis by age. The result of this analysis appears on the third day - the time when the response of the immune system to tuberculin reaches its maximum, then it is already possible to determine what size the sample turned out to be and whether it corresponds to the normal size of the vaccine.

General description of the procedure

Many people remember how this study is carried out: the doctor puts a small injection, injecting a transparent substance under the skin, after which he urges not to wet or scratch his hand in the coming days. In this case, tuberculin is injected under the skin - a preparation containing heat-treated, aged mycobacterium tuberculosis. Mycobacteria treated in this way are not capable of harming the body, but it reacts to them in a certain way.

This is the idea of ​​the test: an organism that already has the tuberculosis virus will respond with a violent reaction to a known pest, causing redness and slight inflammation at the injection site.

Dimensions and Mantoux reaction, normal in adults

It is by the size of the inflamed tissues that the result of the test is determined. So, the Mantoux test: sizes, norm in adults are the following indicators:

• papule (seal at the injection site of tuberculin) less than four millimeters in size;
• redness. By itself, it can be of any diameter and is not a cause for concern;
• no reaction.

The latter option is quite rare and means that the body is either not familiar with this pathogen, or does not suffer from any form of tuberculosis.

Photo of the Mantoux test is normal

Photo 1. How Mantoux should look like for tuberculosis, the norm. The photo shows what size Mantoux should be in the norm.

Photo 2. What the Mantoux reaction looks like, the norm in adults. The photo shows what the Mantoux reaction should be in the norm. Papule less than 4 mm in size.

In the event that a person has had tuberculosis several times, and there is no reaction to Mantoux, we can talk about a false negative reaction - a case when the body stops responding to tuberculin.

INTERESTING: Initially, the Pirquet method was used, in which the patient's skin was damaged by a special scarifier with tuberculin applied to it. It was decided to abandon this method, since the wounds opened access to other infections in the body.

In addition, in some cases, we can talk about a false positive reaction - the case when the papule reaches exactly four millimeters. At the same time, it cannot be denied that tuberculosis is still present in the body. This is usually caused by the following factors:

• allergy;
• recent vaccination or illness. At the same time, the body has not yet fully recovered and its immune responses are increased;
• infection with any other mycobacterium. Since tuberculosis belongs to the type of mycobacteria, up to a certain point the immune system reacts to it in the same way as to other representatives of this species. This means that if there are “related” bacteria in the body, it will interact with tuberculin especially violently.

In this case, the reaction can be judged based on whether the patient has been in contact with tuberculosis patients. Living in places where the disease is very common may indicate a possible infection. A positive reaction to the Mantoux test is the formation of a papule, the diameter of which is more than five millimeters.

In case of a positive or doubtful reaction, a consultation with a phthisiatrician and additional studies will be required to confirm or refute the reaction.

IMPORTANT: Now diaskintest is gaining more and more popularity. This is a new version of the Mantoux test with a modified active ingredient. As practice shows, this type of study is more accurate and has fewer side effects than the classic one.

Contraindications. When is vaccination not recommended?

Like other types of diagnostics, the procedure has its own contraindications and acceptable standards. Some of them are related to the fact that they can harm the patient himself.

Others are temporary and may affect the conduct of the test, distorting its results.

• acute form of any disease and the postoperative period. In this case, the immune system may respond inadequately to tuberculin, which will lead to the growth of the papule and give an incorrect result;
• skin diseases. In some cases, the very nature of the disease suggests the formation of papules, which also does not allow you to get an accurate result;
• bronchial asthma. In rare cases, the introduction of tuberculin leads to a cough, which adversely affects health;
• allergy to tuberculin or components of the sample composition. This type of allergy is quite rare, but it exists and can be accompanied by poor health. Unfortunately, this type of allergy is most often determined during the test;
• rheumatism and epilepsy. There is an opinion that tuberculin can lead to an attack or exacerbation of these diseases.

If any of these contraindications exist, other tests related to sputum, blood and other indicators are performed.

IMPORTANT: Due to the recent growing anti-vaccination movement, the need for this study is increasingly being raised. According to the guidelines of the Ministry of Health, the Mantoux reaction test is mandatory, as this is the easiest way to control the spread of the disease among the population and prevent a pandemic. Mantoux vaccination is the norm. You must protect yourself and your loved ones.

Side effects

When conducting a Mantoux reaction test, the following side effects may occur:

• cough. It is not related to tuberculin itself and is usually psychosomatic;
• allergy. As already mentioned, a person may have an allergic reaction to this drug, which itself is an allergen;
• temperature increase. It is quite rare and in those people who are very sensitive to this drug. The increase in temperature is insignificant and does not affect well-being;
• Hyperergic reaction. Extremely acute reaction of the body to tuberculin. The papule looks unhealthy and grows up to seventeen millimeters, serious inflammation can begin, and in rare cases, necrotic changes in the form of an ulcer or small abscess at the injection site. This extremely rare manifestation of the reaction means that the body is already seriously infected with tuberculosis and immediate treatment is required.

Such reactions of the body are quite rare, most people tolerate the study very easily, without encountering any of the above effects, which served as the prevalence of this method.

IMPORTANT: Tuberculosis is a fairly common disease that may not manifest itself for a long time until immunity is weakened. In this regard, it is especially important to check your health in order to prevent the development of the disease and infection of others.

Taking care of the injection site so that the TB test is reliable

In order for the reaction to the Mantoux test to be the most reliable, a few simple requirements for caring for the injection site should be followed:

• do not scratch the injection site. The papule may itch, this is a normal Mantoux reaction, this is how the body reacts to an irritant. If it is combed, it can grow, which will give an incorrect result;
• seal or otherwise restrict air access to the injection site. The effect will be the same as when visiting the steam room - a possible slight growth of the papule;
• do not smear the injection site with creams, brilliant green and other substances that can cause irritation;
• do not eat foods that can cause allergies. As with any other testing, allergic reactions can affect the result of the test. The same applies to some drugs that can have a similar effect.

IMPORTANT: Despite the first very common misconception, Mantoux can be wetted. You can even calmly wash in the shower, the main thing is not to rub the injection site with a washcloth. This misconception appeared after the first tests, which involved skin incision followed by tuberculin infusion.

Diaskintest is more accurate and has fewer side effects.

Thus, the Mantoux test is the most accessible, popular and cheap method for diagnosing tuberculosis. Due to the ease of manufacture of tuberculin, it is widely used to this day, allowing mass testing of people of any age for tuberculosis, although it cannot boast of the 100% accuracy that more expensive laboratory tests have.

For example, the Mantoux reaction test is carried out in most schools, kindergartens and clinics. These studies are planned and mandatory for all children who do not have contraindications. You can also conduct this study for a fee, but there is no significant difference between private and public institutions.

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Reaction to Mantoux - Basic norms and deviations, advice from doctors

Few parents know what an enlarged mantoux means in a child: is it bad or good, the Mantoux test is a procedure that allows you to check the body for the presence of such a Mantoux test is carried out in the mass diagnosis of tuberculosis using intradermal injection of a tuberculosis allergen. Purpose At the moment, there are a lot of diseases that are secretive. A person can live normally Tuberculosis is a fairly serious bacterial disease, which in some cases causes death. Sometimes in children, the reaction to Mantoux may seem positive. But you should not fall into it immediately. To determine the infection of the body with tuberculous mycobacteria, a diagnostic examination is carried out in the form of a Mantoux test. Every parent knows that a child requires careful attention to their health. A small person in Tuberculosis is a terrible disease, and even worse is that it can be completely asymptomatic. Mantoux for tuberculosis is an immunological test that shows the presence or absence of a bacillus in the body

We have known about the Mantoux test since school. But in fact, it turns out that all our knowledge boils down to the fact that the injection site cannot be wetted and rubbed. Many mothers consider Mantoux to be vaccinated against tuberculosis and categorically refuse to give it to their child.

In fact, tuberculin diagnostics (Mantoux test) is a test of the strength of immunity that has formed against the tuberculin bacillus after a previous vaccination. When the drug is injected under the skin, the body reacts with inflammation.

What does the Mantoux test give?

After conducting the test, doctors can find out if there is a Koch stick in the body, and, possibly, they will confirm the presence of tuberculosis in a child. If there is no immunity to the drug by the age of 7 and 14, it is necessary to revaccinate.

Why do Mantoux if the child is not in contact with tuberculosis patients?

It is a mistake to believe that there are no patients with this dangerous disease in the environment of the baby. Today, many certificates are bought, there is no guarantee that there will be no infected people in transport, on the playground or even in a child care institution. Are you sure that there is no more tuberculosis? When was the last time you had a x-ray?

Is everyone allowed to do a Mantoux test?

Doctors say with confidence that this procedure is necessary for children who do not have serious pathologies and are healthy at the time of the test.

However, there are cases when it is contraindicated:

1. children under 1 year of age do not need this test
2. with exacerbation of chronic diseases;
3. during quarantine for childhood infections;
4. with allergies and acute infections;
5. with epilepsy.

Tuberculin does not contain tuberculosis microbacteria, which means that it does not affect the immune system and the state of the body as a whole.

Is it really possible to wet the puncture site?

There is no need to take care of this place in a special way. Wetting and scratching is not recommended, so as not to cause additional irritation in the tissues. If water does get in, blot with a towel and do not lubricate with brilliant green or peroxide.

What are the dimensions of a normal papule?

Doctors give such designations:

• 1-2 mm - the reaction is negative
• 2-4 mm - doubtful reaction;
• 5-9 mm - a positive reaction of medium intensity;
• 10-14 mm - positive intense reaction;
• 15-17 mm - pronounced reaction;
• more than 17 mm - hyperergic reaction. Reason to see a phthisiatrician.

The result is checked after 3 days.

How does the body react to Mantoux?

As with any drug, the body can react differently. Sometimes the temperature rises slightly, and during the first day a rash appears. Symptoms quickly pass and do not adversely affect the child.

medtub.ru

Every parent knows that a child requires careful attention to their health. A small person in the first years of his life has a weak immune system and the duty of mothers and fathers becomes to protect the child from external irritants, infections and diseases. Each negative change in the child's body is a signal to seek medical help. This article will discuss the main reasons why Mantou blushed on the first or second day and recommendations on what to do in this case.

What you need to know about the Mantoux reaction

An immunological test allows you to accurately determine whether there is a causative agent of tuberculosis infection in the body. Simply put, this is the body's reaction to purified tuberculin. After the injection, a slight swelling is formed on the skin, accompanied by slight redness.

Mantoux is not a vaccine, but still occupies one of the first places in the Russian vaccination calendar. Previously, the mixture for injection was an extract from the substrate of Koch sticks, thermally purified. It is known that such a vaccine had a lot of negative aspects, could cause an allergic reaction, sometimes gave a false reaction. To date, the mixture for vaccination has been significantly modernized and is a purified tuberculin protein with the addition of sodium chloride and stabilizers. Such a composition practically does not provoke the occurrence of allergic reactions, and the accuracy of the test increases several times.

At what age should Mantou be done?

The issue is quite controversial and to this day among doctors there are discussions on this topic. Basically, most doctors recommend vaccination from 12 months, explaining this decision by the fact that the body of a child who has not reached the age of one year will not be able to adequately respond to the vaccine composition received. This is due to changes in immunity that occur in the first months of life. With age-related changes in the immune system, the result may be inaccurate or false negative. Other experts recommend vaccination from the first days of a child's life. No contraindications were found for one and the second method, so the decision on the vaccination period should be made by parents.

The injection itself is quite painless and rarely causes discomfort. The injection site does not require any special care. To identify the correct reaction, you must adhere to several recommendations, namely:

1. for two days you should not wet the injection site;
2. the papule should not be treated with antiseptic substances, they have an anti-inflammatory effect and can neutralize the immune response;
3. do not wash the injection site with various soap-containing compounds.

Deviation or norm?

2 or 3 days after the tuberculin injection, a small patient has a thickening of the skin, the tissues in the center and around the injection become red. You can adequately evaluate the results of the Mantoux test after 72 hours. It all starts with an external examination.

Hyperemia - visually the absence of any reaction. The skin is without redness and generally looks like intact skin. Infiltrate - the skin at the injection site is significantly thickened and has a slight redness.

• negative - in the absence of any traces on the skin and redness;
• doubtful - there is slight redness, but there is no compaction at the injection site;
• positive - a small seal of 5 mm or more is formed at the injection site. Sometimes the injection mark is a large papule, from 15 mm. Such a reaction is called strongly pronounced.

When should you see a doctor?

You should know that a positive result is not at all a peremptory evidence of the presence of a disease. There are several factors that indicate abnormalities in the child's body. It is very important to consider all these factors and understand when the help of a TB specialist is needed:

1. sensitivity to tuberculin, increasing every subsequent year;
2. short contact with a person who suffers from an open form of tuberculosis;
3. the presence of relatives suffering from tuberculosis;
4. an unexpected increase in the papule by several millimeters.

If the child has an allergic reaction

In medicine, there are cases when an allergic reaction to an injection was detected in young patients. An experienced phthisiatrician in such cases conducts a thorough examination of the patient, palpates the injection site. If there is no need for additional tests, the doctor makes a conclusion. An allergic reaction may occur to serum components. This happens quite rarely and in cases of using low-quality tuberculin.

The next reason may be the predisposition of the child to allergies. Among the reasons are: heredity, various chronic diseases, atopic dermatitis. Symptoms may be as follows: nausea, vomiting, loose stools, fever, redness of the skin.

A similar reaction of the body occurs if the child had some infectious diseases before vaccination. Immunity is reduced, and, consequently, the Mantoux reaction causes a number of unpleasant symptoms that require immediate elimination. An incompetent doctor may suggest a number of medications to eliminate an allergic reaction, but this is not enough. Parents should insist on an alternative tuberculin test.

In what cases it is not necessary to do Mantoux

There are a number of contraindications for which you should not be vaccinated. You need to get advice from the child's doctor and determine how appropriate it is to inject. Vaccinations can adversely affect the Mantoux reaction, so the test is best done at least six months before the mandatory vaccination. If the child had a cold the day before, it is better to postpone Mantoux for a month. The test should not be carried out if:

• the presence of various infections in the body;
• susceptibility to allergies;
• rashes on the skin, the presence of skin diseases;
• frequent seizures of epilepsy;
• mental illness.

Blushed Mantoux on the first day

There are cases when, on the same day or the next day, a red papule formed on the child’s arm at the injection site. Mantu blushed literally on the first day. Carefully examine the child for an allergic reaction to the sample. Even if everything is in order with the child, the state of health is satisfactory - you should immediately contact your local doctor to clarify the cause of such a reaction. Experts recommend evaluating the results after three days, but if you initially noticed a strong swelling of the skin at the injection site, you should not waste time.

If the redness does not go away, and the papule is huge and becomes larger every day, this is a serious reason to go to the hospital. Initially, it is necessary to make sure that the child does not suffer from tuberculosis, and such a reaction is a kind of response of the body to the test, caused by many reasons: BCG vaccination, a recent infectious disease. To clarify the reasons, it is necessary to pass additional tests.

What other diagnostic methods can be used?

Many parents consciously do not want to conduct a Mantoux test, and therefore come in search of alternative diagnostic methods. Medicine has advanced over the past few years and can offer several safe techniques that have virtually no contraindications and are well tolerated by children.

• Diaskintest is a relatively new method for determining the presence of a disease. A feature of this method is that the test is intradermal and works according to the Mantoux principle. Depending on the intensity of the reaction, it is possible to accurately determine whether the child is sick or not.
• Interferon test, immunological diagnosis of tuberculosis is one of the ways to accurately determine the presence or absence of a disease without any harm to the body. For this, blood is taken from a vein, after which it is subjected to contact with microbacteria. Most physicians familiar with this method note the high efficiency of the method and the high reliability of a positive result.

The only disadvantage of these methods is that not every city can do them. As a rule, such diagnostics can be offered by private centers or medical institutions in megacities. Of course, the service is paid, unlike the usual Mantoux test.

Outcome

Before deciding on the need for a Mantoux test, it will not be superfluous to consult a pediatrician and weigh all the pros and cons of this procedure. If for some reason you decide to abandon this method of detecting a disease, it makes sense to use the more gentle diagnostic methods described in this article. Take care of the health of your children and at the slightest change in the child's body, be sure to consult a doctor.

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Mantu blushed on the first day or on the second day and became big

If the size of the swelling after Mantoux vaccination is 20 mm or more, this is already a cause for concern for both the doctor and the patient. But Mantoux does not always blush and increase due to the actual presence of the disease, there are also false reactions caused by various factors. What should be the Mantoux reaction, why does the injection site turn red and enlarge, and how can the doctor not make a mistake with the diagnosis?

What is the Mantoux reaction

This test determines the presence of tuberculosis infection in the body of the subject. Often the Mantoux test is also called the tuberculin test. Despite the fact that in fact it is not a vaccine, Mantoux has its place in the all-Russian vaccination calendar. The test is even given to children who, due to their state of health, were exempted from the need to be vaccinated (the so-called medical challenge).

The Mantoux test is a dose of purified and neutralized tuberculin protein isolated from mycobacteria.

A French doctor by the name of Mantoux invented the subcutaneous method of introducing protein, and this test was named after him.

Previously, alttuberculin was used in diagnostics - an extract from the substrate of Koch's sticks, which was neutralized by heat treatment. This old sample contained a significant percentage of impurities, which often caused allergies, enlargement and redness of the injection site, and, as a result, false positives of the test.

Today, doctors use purified protein without foreign inclusions. This substance is much less likely to provoke allergies, as a result, the accuracy of the test increases many times over. But the composition also contains the preservative phenol, a special stabilizer and sodium chloride, which are potential allergens. That is why testing according to the Mantoux method does not give one hundred percent accuracy of the study, and, in case of doubtful reactions, requires additional tests and diagnostics by alternative methods.

Testing according to this method is carried out once a year to identify possible infection of the body with Koch's bacillus.

The bacteria may be latent, and the symptoms of tuberculosis may not appear clearly, but the Mantoux test will already be able to determine the presence of an infection. This is evidenced by an increase in swelling at the injection site by 4 millimeters, compared with the previous test.

The sample is also used to determine if the BCG vaccine needs to be repeated. A negative Mantoux reaction in a vaccinated child indicates the need for revaccination.

What could be the reaction to the test

When staging the Mantoux reaction, a small dose of tuberculin is injected under the skin (measured in conditional TE - tuberculosis units). After the injection, lymphocytes collect at the injection site, swelling forms under the skin, and the skin itself turns red.

The intensity of these phenomena depends on the "acquaintance" of the organism with the Koch stick:

• if the bacteria have already entered the body, and the immune system is familiar with them, then it produces specific anti-tuberculosis lymphocytes that go to the injection site, and it turns red and swells;
• if there was no infection, then the injection heals without a trace.

The reaction is measured on the 3rd day.

Today, the immunity of almost every person is "familiar" with tuberculosis. This happens thanks to the BCG vaccine, which is massively administered to babies in the hospital. This vaccine contains specially weakened bacteria (and not extracts and remnants of pathogens, like some other serums). Thus, the immune system is trained to fight them.

Results may vary. Taken a year after the first vaccination, the Mantoux reaction should show the size of the swelling up to 10 millimeters, this figure is within the normal range. Further, over time, the swelling decreases, since over the years, cellular immunity will also decrease until the result becomes negative. If this happened before the child reaches the age of seven, he is sent for a second vaccination session.

In medicine, a certain period has been adopted, which must pass from the moment of subcutaneous injection to the removal of the results: 3 days. On day 3, the doctor visually assesses the injection site and makes a decision about the presence / absence of infection and the need for additional tests.

After 3 days, the injection can become either barely noticeable (which is rare today), or vice versa, change into a large red area. In this case, the injection site can either thicken, forming a swelling - a papule - surrounded by redness, or simply turn red. To assess how the body reacted to the introduction of tuberculin, they measure not the total diameter of the red spot, but only the size of the papule itself. If Mantoux turned red on the first day, this is an alarming sign, but not necessarily indicative of an illness, this will be discussed below.

The results of the test are evaluated not only one-time, but also in dynamics: over the years, the size of the “response” of the body can either decrease or increase.

The results are divided into three types:

1. Positive. Accompanied by both redness and the presence of compaction after the prescribed number of days. This indicates the activity of Koch's bacillus in the body and the presence of specific lymphocytes in the blood. You can get infected naturally (transmission of mycobacteria from the patient). A positive result may indicate an immune response after the BCG vaccine is given. The Mantoux reaction can be expressed in different ways: if the seal is up to 9 millimeters, it is considered weak, from 10 to 14 - medium, up to 16 mm - pronounced, and if the papule grows beyond these sizes (17-20 millimeters or more) - excessive. The latter may be accompanied by inflammation of nearby lymph nodes and the formation of sores on the skin.
2. Negative - the place is not reddened and without compaction.
3. Doubtful - there is redness, but no induration.

What to do if the Mantoux injection site turns red and enlarges?

If a person after 3 days (or earlier, even on the first day) has an increase in papule and redness of the skin in this area, in this case, you should immediately contact your local doctor. If tuberculosis is suspected, he will write a referral for treatment to a tuberculosis hospital.

There, the phthisiatrician will conduct all the necessary tests, including fluoroscopy of the lungs, blood and sputum tests.

Even if the tests do not confirm the presence of an active infection in the body, the doctor may prescribe a preventive course of treatment.

This is done in order to ensure that a dangerous pathological process does not develop.

But you need to remember that even if Mantou blushed, this is not a 100% accurate method. Redness on day 3 or 1 may be caused by allergies, water intrusion at the injection site, or rubbing/scratching of the injection site. Even causes such as a runny nose or medication can affect the result. Therefore, before sounding the alarm, it is necessary to contact specialists and conduct a full examination, which includes sputum and blood tests using various methods. Only a comprehensive analysis will make it possible to reliably calculate the presence / absence of a disease, determine the status of its course and prescribe an adequate treatment.

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This dangerous disease with a formidable name has a rich history. Doctors began to detect tuberculosis symptoms and the first signs of its presence were found in the spines of Egyptian mummies.

Tuberculosis is curable or not

Tuberculosis is an infectious disease that most often affects the lungs. Specialists distinguish two types of infection:

1. active;
2. latent.

In the second form, bacteria are present in the human body, but are in a "dormant" state. In this case, the disease is not transmitted to other people . Tuberculosis symptoms, the first signs do not appear, this does not allow one to suspect its presence. However, mycobacteria are able to move into the active stage. In this case, they cause a number of characteristic symptoms, and can also be transmitted to others.

In the 80s, a rapid increase in the incidence of tuberculosis in the world began. As a result, in 1993 this disease was declared one of the global problems of mankind. How to understand tuberculosis is being treated or not?

Fortunately, with the right treatment almost all cases of tuberculosis are curable.

The number of infected people has decreased significantly in recent years, but the problem still remains. Due to the lack of proper treatment, about 2/3 of people with tuberculosis die.

How can you get tuberculosis

It is estimated that carriers of latent TB make up about one third of the world's population. The probability of the transition of the disease to the active form is about 10%. This risk increases significantly for people who have a weakened immune system:

• smokers;
• People suffering from malnutrition;
• With HIV infection.

It has been proven that smoking increases the likelihood of tuberculosis becoming active. According to statistics, more than 20% of cases worldwide are associated with this bad habit. disease risk how can you get tuberculosis people of all ages living in any regions of the world are affected. Tuberculosis symptoms The first signs most often affect young people and residents of developing countries. Above, we read that the answer to the question of tuberculosis is treated or not is a definite yes. But general unfavorable living conditions are also a factor that largely determines the likelihood of acquiring the disease.

How tuberculosis is transmitted from person to person

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, which is transmitted through the air by coughing, laughing, sneezing or talking. The disease is a contagious (contagious) infection.

But the bacterium does not easily take root in the body if the human immunity is normal. One way or another, the chances of getting infected from a colleague or household member are much higher than from a stranger. Most patients who receive appropriate treatment are no longer contagious.

Since antibiotics have been used to fight TB, certain strains have become resistant to them. Multidrug resistance (MDR) occurs when an antibiotic fails to kill all the bacteria it targets. After that, the remaining ones develop resistance to it, and sometimes to all drugs of this group. MDR disease can only be cured with the use of specific, hard-to-find anti-tuberculosis drugs, which are often limited in number.

While the latent stage does not manifest itself in any way, with active pulmonary tuberculosis, symptoms in adults and children appear as follows:

• Cough, in some cases, impurities of blood or mucus are found in the sputum;
• Chills;
• Fatigue;
• Fever;
• Weight loss;
• Decreased appetite;
• Sweating in sleep.

This infection usually affects the lungs, but there are cases of its manifestation in other parts of the body.

With the development of tuberculosis outside the lungs, the symptoms of the first signs in adults and children change accordingly.

In the absence of proper therapy, tuberculosis can pass to other organs through the blood:

• Bone damage by mycobacteria can lead to back pain and joint destruction;
• Brain damage causes meningitis;
• The consequence of infection of the kidneys and liver is the deterioration of their function;
• Involvement of the heart can lead to pericarditis and cardiac tamponade.

Diagnosis of pulmonary tuberculosis in the early stages in an adult

First, the doctor listens to the lungs with a stethoscope, feels the lymph nodes for enlargement. Also, an anamnesis is taken, an assessment of the risk of developing tuberculosis.

The most common diagnostic test for tuberculosis is the tuberculin test, known as the Mantoux test. To do this, a small injection of tuberculin type PPD is given, after a few days the injection site is checked for a reaction. Unfortunately, the tuberculin test is not a 100% guarantee of the detection of the disease.

It is considered normal if after Mantoux there is only redness, and the size of the papule does not exceed that indicated in the table below

Mantoux for tuberculosis is the norm in children Komarovsky video

Dr. Komarovsky shares his experience on the mantoux norm for tuberculosis for children

There are other ways to diagnose tuberculosis symptoms the first signs in adults and children:

1. Blood tests;
2. chest X-ray;
3. Sputum diagnosis.

It is most difficult to detect tuberculosis in children, as well as the type of disease with MDR.

Tuberculosis of the lungs treatment

The good news is that most cases of TB symptoms are the first signs in adults and children and can be treated, provided that the therapy is properly selected and timely. The method and duration of antibacterial treatment depends on the form of the disease (latent or active). As well as other factors (health status, age of the patient, potential drug resistance). It also matters which organs are affected by the disease.

Pulmonary tuberculosis treatment with antibiotics

Patients with latent TB may only need one type of antibiotic. While carriers of the active form of the infection (and especially the type of disease with MDR) often require several different drugs.

Usually antibiotic therapy is carried out for a relatively long time. The standard duration of antibiotic treatment is about six months. All medicines aimed at combating tuberculosis are a danger to the liver, as they are toxic substances.

Given the fact that side effects are relatively rare, it must still be remembered that if they occur, they can lead to serious problems. Possible side effects known to medicine:

• dark color of urine;
• fever;
• jaundice;
• loss of appetite;
• nausea and vomiting.

Even in the case of the disappearance of tuberculosis symptoms, the first signs in adults and children, it is important to complete the treatment. This is important because any bacteria not killed during treatment can become resistant to antibiotics, which can subsequently lead to the development of MDR TB.

Pulmonary tuberculosis treatment and prevention

Prevention methods are usually aimed at preventing the spread of active forms of tuberculosis between people. The most obvious of these are recommendations:

1. To reduce the frequency of contact with carriers of the disease;
2. Wearing a protective mask;
3. Frequent ventilation of the premises.

The Mantoux reaction (Mantoux test) is used in tuberculin diagnostics. Tuberculin diagnostics is the main method for identifying those infected with tubercle bacilli, persons at increased risk of the disease and patients. For these purposes, the Mantoux test (Mantoux reaction) is used. Its dimensions make it possible to judge the presence of tubercle bacilli in the child's body.

The intensity of the tuberculin reaction varies. The Mantoux reaction is registered as normal, negative, positive, hyperergic and doubtful. The Mantoux reaction will tell the doctor whether or not he is ill, how high the degree of infection with tubercle bacilli, whether or not the child needs to be given preventive treatment or vaccinated against tuberculosis. There are contraindications to the Mantoux reaction, which are identified by medical workers on the eve of the tuberculin diagnosis.

Infection is the penetration of the pathogen into the child's body without the development of clinical symptoms of the disease. The development of tuberculosis is prevented by immunity.

With a tuberculosis infection, the human body most often occurs in childhood and subsequently never leaves this meeting without harming itself. Tuberculosis bacillus, once entering the human body, never leaves it. It hides in the organs of the reticuloendothelial system (RES) and in the future may become the culprit of the disease. The interaction of a tubercle bacillus with a child's body is quite complex. Tuberculosis is especially dangerous for children from 1 to 3 years old. Infection of the first year of life always ends with a disease.

Rice. 1. In the photo, Mycobacterium tuberculosis (electronogram, negative contrasting).

To identify children infected and sick with tuberculosis is the task of the RFC.

Tuberculin diagnostics

Tuberculin diagnostics (Mantoux test) is carried out on a mass and individual basis for all children vaccinated against tuberculosis from the 1st year of life. If for some reason the child was not vaccinated against tuberculosis in the maternity hospital, then the Mantoux test is carried out for him 1 time every six months until the moment of vaccination.

Tasks of tuberculin diagnostics

• Timely detection of infected with tuberculosis bacilli, persons with an increased risk of disease and children with tuberculosis.
• Selection of children for vaccination and revaccination (vaccination against tuberculosis).
• Based on the results of tuberculin diagnostics, one can judge the epidemic situation of tuberculosis in a particular region.

Tuberculin diagnostics is an important method for screening children and adolescents for tuberculosis worldwide.

What is tuberculin

Tuberculin is a complex drug that is made from cultures of filtrates of tubercle bacilli or from the pathogens themselves. Being an incomplete antigen (hapten), it causes a special immunological reaction, which manifests itself after 24-72 hours.

How is tuberculin diagnosis performed?

• Tuberculin diagnostics is carried out by a specially trained nurse, in a separate room, with special tuberculin disposable syringes.
• Tuberculin is injected intradermally into the middle third of the forearm.
• At the injection site, a papule should form, which looks like a "lemon crust" no more than 9 mm in diameter, whitish in color. The papule disappears very quickly.
• The response is evaluated after 72 hours, the data on which are recorded in special documents - the vaccination card, the medical record and the history of the child's development.

Rice. 2. Tuberculin is administered intradermally.

Rice. 3. At the injection site of tuberculin, a papule should form, which looks like a “lemon peel”, no more than 9 mm in diameter, whitish in color.

Rice. 4. Carrying out mass tuberculin diagnostics at school.

Reactions to the introduction of tuberculin

The child's body reacts to the introduction of tuberculin with local and general manifestations:

Local manifestations

Its formation occurs at the site of tuberculin injection, where a papule or reddening of various sizes may form, vesicles (vesicles), necrosis and lymphangitis may appear. It is the local reaction that is of great diagnostic value. The Mantoux reaction can be negative, doubtful, positive and hyperergic.

General manifestations

The general reaction occurs rarely and is characterized by a deterioration in general well-being in some children, fever, headaches and joint pain.

Focal reaction

Occurs with tuberculosis in the foci of tuberculosis infection.

Mantoux reaction is used for tuberculin diagnostics.
(Mantoux test) with 2 tuberculin units (2TE).

Rice. 5. In the photo, tuberculin is a complex drug that is used for tuberculin diagnostics.

Contraindications for carrying out tuberculin diagnostics

Contraindications for tuberculin diagnostics are:

• skin diseases,
• infectious diseases in the period of exacerbation,
• somatic diseases during an exacerbation (including epilepsy),
• tuberculin tests are not carried out in children's groups subject to quarantine for an infectious disease,
• Mantoux test is not given during the first month after other preventive vaccinations.

Tuberculin diagnostics can be carried out one month after the removal of quarantine or the disappearance of clinical symptoms of a somatic or infectious disease.

Before tuberculin diagnostics, all children are interviewed and examined by a doctor or nurse, medical records are carefully studied.

Evaluation of the results of tuberculin diagnostics

• Evaluation of the results of the Mantoux reaction is carried out after 72 hours.
• Before measuring the result, palpation of the tuberculin injection site is performed to determine the presence or absence of a papule.
• In the presence of papules and hyperemia, only papules are measured.
• Measurement of papule or hyperemia is carried out with a transparent ruler, which is located perpendicular to the axis of the forearm.

Rice. 6. In the photo, a medical worker evaluates the results of tuberculin diagnostics. Measurement of papule or hyperemia is carried out with a transparent ruler, which is located perpendicular to the axis of the forearm.

Rice. 7. Measurement of papule or hyperemia is carried out with a transparent ruler.

Mantoux reaction is negative

The Mantoux reaction is negative if there are no papule and hyperemia, or only a prick reaction no larger than 0.1 mm can be seen at the tuberculin injection site. She says that the child is not infected with tubercle bacilli, or there was a biological self-healing from tuberculosis.

The Mantoux reaction can be negative in the following diseases:

• when a child becomes ill with a severe form of tuberculosis,
• with lymphogranulomatosis, sarcoidosis and a number of acute infectious diseases - measles, rubella, mononucleosis, scarlet fever, typhoid and neoplasms,
• with avitaminosis and exhaustion.

Rice. 8. In the photo, the Mantoux reaction is negative. At the injection site of tuberculin, a prick reaction of no more than 0.1 mm in size.

Mantoux reaction is questionable

A reaction to the introduction of tuberculin is considered doubtful if the size of the papule is from 2 to 4 mm, or hyperemia (redness) of any size is recorded, but without infiltration.

Rice. 9. In the photo, Mantoux's reaction is doubtful. Hyperemia without papule.

Mantoux reaction is positive

A test for tuberculosis is considered positive if the papule is 5 or more millimeters, the presence of vesicles (vesicles with liquid) may be noted, or additional formation of papules around the main papule formed at the injection site is noted.

The positive Mantoux reaction is interpreted as:

• weakly positive - papule from 5 to 9 mm,
• positive medium intensity - papule from 10 to 14 mm,
• pronounced - papule from 15 to 16 mm,
• hyperergic - papule 17 mm or more, this also includes the formation of vesicles with a necrotic component, the presence of lymphangitis and foci of screening around the papule.

Rice. 10. In the photo, the Mantoux reaction is positive.

Rice. 11. In the photo, the Mantoux reaction is positive hyperergic. Large hyperemia and papule more than 17 mm.

Rice. 12. In the photo, the Mantoux reaction is positive hyperergic. A large vesicle is visible against the background of hyperemia.

Hyperergic Mantoux reaction

Most often, hyperergic tests for tuberculosis are detected in children with tuberculosis. Its manifestation is influenced by the use of penicillin and streptomycin. A hyperergic reaction is fixed with allergies and allergic dermatosis. Chronic inflammatory diseases contribute to its occurrence. Children with hyperergic reactions are referred for a consultation with a phthisiatrician.

Rice. 13. In the photo, the Mantoux reaction is positive hyperergic. Papule with vesicle.

Rice. 14. In the photo, the Mantoux reaction is positive hyperergic. Papule with vesicle.

Rice. 15. In the photo, the Mantoux reaction is positive hyperergic. Papule more than 17 mm.

Turn of tuberculin tests

The moment of primary infection is indicated by the first-ever positive Mantoux test, unless this condition is associated with vaccination or revaccination. Children with a tuberculin test turn represent the most threatened group in terms of tuberculosis. The turn of tuberculin tests is the first indication for referral to a phthisiatrician.

Increased tuberculin sensitivity

Tuberculin sensitivity increases with helminthic invasion, food allergies and acute respiratory diseases, with infection with tubercle bacilli, hypothyroidism, allergies, viral hepatitis, obesity, etc.
About 70% of sick children with tuberculosis are detected with increased tuberculin sensitivity. Such children are subject to treatment within 3 months.

If an increase in tuberculin sensitivity is registered as a hyperergic Mantoux reaction (a papule of 17 mm or more), then it is considered that the risk of developing tuberculosis in a child is extremely high.

Rice. 16. Staging the Mantoux reaction during a viral infection can give an increase in tuberculin sensitivity.

Monotonous tuberculin sensitivity

According to statistics, in children with the same results of the Mantoux test for 3 years, tuberculosis was detected in 36% of cases.

The study of the Mantoux test in dynamics

The study of the Mantoux test in dynamics (by years) makes it possible to identify the following groups of children and adolescents based on the results of mass tuberculin diagnostics:

• children and adolescents with a negative Mantoux reaction (uninfected children) and those with post-vaccination allergies;
• children and adolescents infected with Mycobacterium tuberculosis.

Allergy to tuberculin injection

Allergy to the introduction of tuberculin can cause phenol, which is a part of tuberculin in a minimal amount. Your doctor will help you deal with an unusual reaction.

Post-vaccination allergy

A positive Mantoux reaction after the administration of tuberculin with 2 TU in persons vaccinated against tuberculosis in the previous year is called post-vaccination allergy. The phthisiatrician has all the knowledge to distinguish post-vaccination allergies from primary infection.

Rejection of the Mantoux reaction

Refusal to conduct tuberculin diagnostics is currently not uncommon. Parents in the modern world are bombarded with a lot of information, including negative information, about Mantoux tests and anti-tuberculosis vaccinations.

Children get TB from adults. Russia is one of the countries with a high incidence of tuberculosis. Therefore, parents should not refuse to conduct tuberculin diagnostics.

Mass tuberculin diagnostics is the only method that allows you to examine almost the entire child population in a short time and quite simply.

Rice. 17. Parents' refusal to stage the Mantoux reaction deprives the child of the right to health.

The Mantoux test—incorrectly referred to as a vaccine by many—measures the body's immune response to an intradermal injection of thermally sterilized and specially treated fragments of tuberculosis bacteria (tuberculin).

This test has been successfully used all over the world for more than 70 years, i.e. the test is being put for the 3rd generation in a row, including in our country. Mantoux in adults shows whether a person is infected or not. For children, its main function is a little different.

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What is this test?

The Mantoux test causes a typical immune response.

In order for the immune system to respond to a particular microbiological invasion, it must be familiar with certain microorganisms. That is, normally, immunity reacts only to those threats that it “recognizes”. Until we recover from an infection (or until we are vaccinated with a vaccine), the immune system cannot begin to recognize it.

If tuberculin bacteria are known to the immune system, then special immune cells will begin to attack the injected tuberculin, causing a local inflammatory reaction.

How is it done?

The injection is made intradermally, i.e., into the upper layer of the skin, specially lifting the skin with the needle up. The place of the test is the forearm, as a rule, its middle part.

Why do they do it?

Since the tuberculin test is done in childhood, many parents are interested in the question of why their children are given Mantoux.

Goals:

• Selection of uninfected children who do not have an immune response to tuberculin for the purpose of subsequent vaccination;
• analysis of the dynamics of results over several years, according to which it is possible with sufficient probability to assume the presence of the Mantoux (“turn”);
• identification of a pronounced (hyperergic) reaction, which always requires additional tests.

Adults usually do not receive the TB vaccine for a long time (most of us from adolescence). Therefore, in adults, the Mantoux reaction is a sensitive and reliable test for the presence of a tuberculosis pathogen in the body.

Up to what age do children?

The test is started from the age of 1 year and put annually until the age of 15 years.

Training

The test is not done during any disease that occurs in an acute form. First you need to heal.

The test method does not require any special preparation.

The composition of the drug

The tuberculin test consists of:

• Fragments of tuberculosis bacteria, thermally and chemically treated;
• stabilizer - twin-80;
• preservative - phenol;
• sodium and potassium phosphates;
• sodium chloride
• water.

Is Mantoux harmful?

The test is completely harmless.

The main claims are made to phenol, which is part of the sample. Phenol is indeed a toxin. But its amount in the injected tuberculin test is so small (0.00025 g) that it does not have any effect on health.

Phenol is a natural metabolite: it is formed in tissues as a result of the activity of bacteria in the intestine. This substance is found in many foods. Phenol entering the blood is decomposed in the liver and excreted in the urine. Every day, about 0.1-0.15 g of such metabolic phenol is excreted from the body. This is several hundred times more than a person with a tuberculin test receives.

The medical use of phenol in low concentrations is justified.

How often can a child do?

Mantoux is done once a year.

With more frequent staging, an amplifying effect is observed: the sensitivity of the immune system to tuberculin increases, resulting in a false positive response.

It makes no sense to test more than once a year.

The norm in children

Tuberculosis immunity after the first vaccination lasts up to 7 years. How much exactly - can be approximately judged by the round scar left from the vaccination on the left shoulder.

Table 1. Preservation of anti-tuberculosis immunity after, depending on the diameter of the post-vaccination scar.

The size of the scar matters when answering the question of what should be the reaction to Mantoux in children.

It depends on the age of the child which Mantoux is considered normal. Let's consider in detail.

Norm at 1 year

During the second year of life, all children have a positive or doubtful reaction to Mantoux.

The norm at 1 year in the presence of any post-vaccination scar is a papule with a diameter of 5 to 10 mm.

Norm at 2-6 years old

By the age of 2, the intensity of anti-tuberculosis immunity is maximum. With a post-vaccination scar of more than 8 mm, the normal size of Mantoux can reach 16 mm.

After 3 years of age, the immune response to tuberculin begins to fade. But still, at 4 and 5 years old, most children retain a dubious or positive reaction. The normal size of a papule at the age of 4-6 years is considered to be no more than 10 mm.

In order to understand what size Mantoux should be at this age, one should correlate the diameter of the papule with the post-vaccination scar:

Table 2. The ratio of the normal size of the papule to the size of the post-vaccination scar in children aged 3-5 years.

At 6-7 years old, children almost always show a negative or questionable answer to the test. This suggests that the immune system "forgets" how to respond to tuberculosis pathogens. A negative reaction at any age indicates the need for re-vaccination. Planned revaccination of all children is carried out at 7 years.

Norm at 7-14 years old

After revaccination at 7 years, the cycle repeats.

• The first 3 years the maximum tension of immunity remains;
• after 10 years, the response to the introduced tuberculin fades;
• by the age of 13-14, most adolescents will have a questionable or negative response to the test as the norm.

Table 3. The norm of Mantoux papule in children 7-14 years old

The norm in adults

The norm in adults is:

• Lack of reaction;
• redness of any diameter;
• papule up to 4 mm.

Reaction by day

The reaction to the introduction of tuberculin appears on the 2nd day. This may be redness and/or papule formation.

The response of the immune system reaches its maximum on the 3rd day.

negative

A negative Mantoux test is the absence of any reaction.

A negative answer means that

• Immunity "does not know" the tuberculosis pathogen;
• a person does not suffer from either active or latent form of tuberculosis.

A negative Mantoux reaction in children vaccinated within the next 5 years is bad. She says that the immune system does not remember a dangerous pathogen.

A negative Mantoux result in children who have been vaccinated for more than 5 years is good. She shows that the child is not infected with tuberculosis. The same is true for adults.

false negative

The immune system of persons infected with tuberculosis ceases to respond to the administered tuberculin over the years. In this case, we speak of a false negative test.

positive reaction

A positive Mantoux test is considered a papule more than 5 mm in diameter.

The child has

Analysis of a positive reaction to Mantoux in a child is always associated with an assessment of two factors:

• The duration of vaccination and the size of the post-vaccination scar;
• the presence of the Mantoux turn - the dynamics of the sample over several years;
• the nature of the papule.

The correlation of a positive result with the duration of vaccination and the size of the post-vaccination scar was discussed above in the section on the norm.

The Mantoux turn is an atypical increase in the response to tuberculin administered over time compared to previous years. Virage is recognized:

• The transition of a negative or doubtful reaction into a positive one;
• papule persistence of more than 10 mm after vaccination for 3 years and beyond;
• an increase in papule compared to the previous test by 6 mm (in practice, any increase is interpreted as a possible infection, for example - 10, 10, 14);
• hyperergic reaction regardless of the time of vaccination.

Important for differentiating a papule that occurs against the background of a vaccine from a papule that indicates the presence of a tuberculosis infection is the nature of the resulting compaction.

At any age, the papule that arose in response to the immunity acquired after the vaccine is always pale pink. The papule, which has arisen in response to infection with a tuberculosis bacterium, is always clearly defined and acquires a brownish tint (pigmentation) during the first week.

In an adult

If the Mantoux reaction in an adult is positive, then this means that with a probability close to 100% vol.

In the absence of the effect of vaccination, this method is the most sensitive and reliable test for tuberculosis.

false positive

A doubtful or false positive answer is considered:

• The appearance of redness of any size;
• the formation of papule with a diameter of up to 4 mm.

A dubious Mantoux reaction means that one or more of the following statements are true:

• The immune system "remembers" tuberculosis;
• have had any recent vaccinations;
• a person is infected with nontuberculous mycobacterium;
• the person has a skin allergic reaction;
• the person has recently had an infectious disease (any).

In differentiating a positive sample from a false positive, factors such as:

• The presence of contacts with carriers of tuberculosis;
• living in an area where the disease is above average.

Complications and side effects

The main side effects are associated with an excessive response of the body to the injected tuberculin.

hyperergic reaction

A papule larger than 17 mm is called hyperergic.

There may be necrotic changes and obvious inflammation in the area of ​​the sample.

A hyperergic response indicates the presence of a tuberculosis infection in the body.

Allergy

Tuberculin is an allergen. It can cause an allergic reaction at the injection site.

If Mantoux itches

The test site may itch. It is necessary to prevent scratching so as not to provoke a hyperergic reaction.

Temperature

In people with hypersensitivity to tuberculin, the temperature may rise slightly.

Cough

Cough is not a side effect of the test. The appearance of a cough after the test is not connected with tuberculin and has more banal reasons.

Contraindications

Testing is contraindicated:

• In the acute phase of any disease;
• with skin diseases;
• with epilepsy;
• with rheumatism;
• with bronchial asthma.

Alternative tests for tuberculosis

A new alternative to the Mantoux reaction - . It is much less likely to give a false positive reaction, but more often - a false negative.

Mantoux is a basic test that precedes a clarifying diaskintest.

What can and cannot be done?

Wetting your hand is not allowed.

It is forbidden. Colds and coughs have an infectious cause. Testing is contraindicated for 1 month. after illness.

Can I swim after the test?

Can. Do not rub your hand with a washcloth, brush, or otherwise irritate the injection site.

Useful video

The Mantoux test and its importance for the prevention of tuberculosis at an early stage are described in detail in the video:

Conclusion

Most parents think that the Mantoux reaction checks to see if the child has TB. However, the test gives a positive result in 80% of cases. In this case, the diagnosis is confirmed in no more than 0.5% -1%, often - not confirmed at all. As we have seen, the purpose of testing children is to get an answer to the question of whether the child will be able to resist real tuberculosis bacteria.

For adults, the Mantoux reaction is the main, most sensitive and accurate way to detect tuberculosis infection.

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Mantoux reaction in adults - the norm and indications for conduction should be evaluated by a doctor. Typically, the Mantoux test is used to diagnose the early stages of tuberculosis in children. For adults, fluorography, laboratory blood and sputum tests are more often used. However, in some cases, for example, if there has been contact with a carrier of an open form of tuberculosis, a Mantoux test can be performed on an adult.

Why are tuberculin tests rarely done for adults? This is due to the fact that this method is not reliable enough. It allows only to assess the risk of the presence of the causative agent of tuberculosis in the body. But as an express diagnostic method, the Mantoux test can be recommended to a patient of any age. Moreover, if the result of the test causes concern to the doctor, more serious tests are carried out.

Many people mistakenly believe that a tuberculin test is a tuberculosis vaccination. Sometimes you can even hear someone say "Mantoux vaccination." However, this is not the case: the test has nothing to do with vaccination and does not affect the body's resistance to Koch's wand.

The essence of the procedure is quite simple: during a diagnostic tuberculin test, tuberculin, which is an extract of tuberculosis pathogens, is injected under the patient's skin. You should not be afraid of infection: there are no living pathogens in the preparation.

The human immune system immediately reacts to tuberculin: T-lymphocytes accumulate at the injection site. In this case, the reaction of the immune system will be expressed if the body already has the "experience" of fighting Koch's wand. And this happens only when a person is infected with tuberculosis or has ever had this dangerous disease. Thus, if there is a causative agent of tuberculosis in the body, the injection site will become inflamed and redden: in this case, they say that the Mantoux reaction gave a positive result.

It is important to note that the test may give false results if the person has recently received any vaccinations.

In order for the doctor to receive accurate data regarding the presence or absence of the causative agent of tuberculosis in the body, it is necessary to follow a number of recommendations:

• the injection site of tuberculin should not be sealed with adhesive tape;
• the sample may itch slightly. It should not be combed: if you injure the injection site of tuberculin, there is a high risk of a false positive reaction;
• it is forbidden to treat the skin at the injection site with antiseptic solutions;
• There is a myth that water should not get on the sample. Do not give up hygiene procedures. True, it is not worth it to wet the sample strongly and rub it with a hard washcloth or towel, as this can distort the result.

Sample evaluation

Three days after the introduction of tuberculin under the skin, the doctor evaluates the reaction of the body. In this case, the dimensions of the so-called papule formed at the site of the sample are measured.

If there is no redness on the skin, there is no slight swelling and no traces of the injection of the drug, the reaction to Mantoux is considered negative. This means that a person is not infected with tuberculosis and there are no pathogens of this dangerous disease in his body. If there is a trace, it must be evaluated. The norm of the Mantoux reaction in adults differs from the "children's" standards.

Mantoux reaction - the norm in adults:

1. If the redness has a small diameter, and the swelling rises above the skin to a height not exceeding one millimeter, the reaction is considered negative.
2. If the redness has a diameter of 1 to 4 mm, the result of the test is doubtful. This result is often interpreted as normal, but if the risk of infection is too high, additional examinations will be prescribed, such as fluorography or chest X-ray.
3. A swelling ranging in size from 4 to 17 mm indicates that the person is infected with Koch's wand.
4. If the size of the swelling exceeds 21 mm, and an inflammatory process or even the appearance of abscesses is noted in the tuberculin area, we can talk about a hyperergic reaction, that is, the highest degree of probability of contracting tuberculosis. In this case, doctors say that the Mantoux test in adults gave a positive result.

It is worth noting that the presence of a seal indicates the presence of infection, but not the duration of the disease. In this regard, such a parameter as the “turn” of the Mantoux test, that is, an increase in the size of the sample compared to the sample made last year, is very important.

False positive reaction

It is important to remember that an enlarged Mantoux test in an adult is not considered an indicator that a patient has tuberculosis. A tendency to allergies or a recent infectious disease can lead to a hyperergic reaction. Therefore, do not panic if the papule is too large: additional examinations prescribed by the doctor will help to find out the cause of the body's pronounced reaction to the causative agent of tuberculosis.

The following factors can distort the result of the survey:

• advanced age of a person;
• the presence of a chronic disease or inflammatory process;
• phase of the menstrual cycle (never done during menstruation: the result will be highly distorted and unreliable);
• skin hypersensitivity;
• individual intolerance to tuberculin;
• incorrect sample setting;
• unfavorable environmental conditions in the place where the patient lives.

To avoid a false positive result, before taking the test, you should warn the doctor about the tendency to allergic reactions or the presence of a chronic disease. Children and adults do not make Mantoux in the presence of epilepsy, as well as during seasonal epidemics.

The Mantoux reaction can be not only false positive, but also false negative. The latter often occurs if the patient has a deficiency of vitamins of group E. Sometimes, the use of low-quality or expired tuberculin for a sample leads to a false negative result. Therefore, if the test turned out to be negative, and the risk of infection is high enough, it is recommended to undergo additional diagnostic tests.

Russia is one of the most unfavorable countries in terms of the incidence of tuberculosis.

Therefore, it is very important to know what the reaction to the Mantoux test should be and regularly undergo fluorography: this will help diagnose tuberculosis at an early stage and promptly begin treatment.