Mantoux test – a way of early diagnosis of tuberculosis

Mantoux test – this is the main method of testing children for tuberculosis. This is a test, the essence of which is expressed in a sample of This test is a skin sample aimed at detecting the presence of a specific immune response to the introduction of tuberculin.

The Mantoux test is actually a type of immunological test that shows whether there is a tuberculosis infection in the body. This test is a means of early detection and prevention of tuberculosis.

Technique for carrying out the Mantoux test

The Mantoux test is performed by introducing tuberculin intradermally into the inner surface of the forearm. Tuberculin is a solution of parts of the casings of the causative agent of tuberculosis, that is, it is an allergen.

Tuberculin does not contain mycobacteria and therefore cannot cause disease.

With technically correct /intradermal/ introduction of tuberculin on the child’s skin, something like a “lemon peel” is formed, and then, with a positive reaction, a pimple appears that looks like a mosquito bite. The tuberculin sample is evaluated after 72 hours /3 days/.

Assessment of the Mantoux test reaction

In children immunized with BCG vaccine, the Mantoux test reaction in the first 4-5 years is usually stable positive – the skin pimple is larger than 5 mm but not more than 16 mm and fades last. This is a completely normal phenomenon, which is called “post-vaccination allergy”.

Mantoux test

Nevertheless, other options are also possible – if the Mantoux reaction is negative in vaccinated children, then the earlier vaccination can be recognized as ineffective and the corresponding child should be carry out revaccination.

The following situations are more alarming, the Mantuto reaction /that is, the skin pimple/ increases more than 6 mm compared to the previous sample, where:

• Bubbles appear near the sample site;
• Lymph nodes become enlarged;
• A red line appears from the sample site to the elbow;

All these are signs of the so-called turning of tuberculin samples, that is, infection with the causative agent of tuberculosis infection. In all these situations, children must be sent for consultation with a phthisiologist – a specialist in pneumology and tuberculosis.

Other situations in which children are sent for consultation with a phthisiologist:

• Initially a positive reaction to the Mantoux test with a pimple with a diameter of 5 millimeters or more, which is not related to vaccination against tuberculosis.
• Too long persistence of the reaction with papule 12 and more millimeters or very long persistence of the Mantoux test reaction with infiltration 12 and more millimeters.
• Increased sensitivity to tuberculin in a child with a previously positive test reaction Mantoux – increase of the infiltrate /papule/ by 6 mm or more or with an infiltrate of 12 mm or more and an increase in its diameter.
• Hyperreaction to tuberculin – infiltrate of 17 mm or more or appearance of small bubbles /vesicles/ and necrosis.

The risk of the hidden infection turning into a real disease in the first year is 15%, therefore consultation with a phthisiologist is extremely important for the early detection of tuberculosis.

Such a consultation allows to exclude the so-called false positive reactions, to determine the need for prophylactic treatment, since therapy in advanced disease is much more complicated.

The refusal of prophylactic treatment in the future can lead to much more serious consequences than the possible side effects of the administration of medicinal products.

The task of the specialist doctor is to determine the ratio between risks and benefits and to present this information to the parents of the child.

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