The merciless fight against tuberculosis is not only treatment in specialized clinics for those suffering from a dangerous disease, but also early detection susceptibility to disease.
This is especially acute for children. The Mantoux test, which is started on children from the age of one, successfully copes with the task.
Mantoux reaction - what is it
More than a hundred years ago, in 1882, humanity learned of the existence of the tuberculosis “Koch bacillus,” named after the German microbiologist who discovered it. Looking for effective means from an unknown disease, Robert Koch, like other researchers around the world, conducted numerous experiments, which resulted in the creation of tuberculin. Despite the hopes placed on it, the drug turned out to be powerless in the fight against tuberculosis, but its discovery was not in vain. In 1908, a physician from France, Charles Mantoux, discovered a difference in the reaction of healthy and tuberculosis patients to the administration of the drug. His discovery marked the beginning of the use of tuberculin as a test for the presence of a dangerous bacillus in the body, and the research method itself was called the Mantoux test.
The annual Mantoux test involves injecting small doses of tuberculin under the child’s skin and monitoring the body’s reaction to this procedure. A slight inflammation may occur at the injection site due to the presence of active lymphocytes. They are responsible for anti-tuberculosis immunity, and their quantity affects the resulting reaction. 72 hours after administration of the drug, the doctor examines the injection site and renders his verdict. The result depends on the presence or absence of inflammation and the size of the compaction.
How often is the Mantoux test performed on children?
On the fourth to seventh day after the baby is born, he is given the BCG vaccine, designed to build immunity against tuberculosis. Exactly one year later, the first Mantoux reaction is carried out, which shows how the child’s immune system behaves when encountering a tuberculosis infection. Before the baby celebrates his first birthday, the Mantoux test is not done, as the result may be incorrect. In the future, it is carried out every year until the age of 14.
If, for various reasons, the BCG vaccination was not done on time, further vaccination depends on the Mantoux reaction - a negative result confirms the absence of the tuberculosis bacillus in the body and indicates the relevance of the BCG vaccination. Positive, if it is within normal limits, confirms the fact of meeting with Koch’s wand and winning a victory over it immune system. In this case, there is no point in carrying out vaccination, but it is advisable to do the Mantoux test on a schedule, annually.
How to care for the Mantoux test in children
The Mantoux test is done for children in the clinic - the drug is injected into the arm. To get the right result, you should follow some simple rules. The resulting “button” cannot be:
Cover with adhesive tape;
Lubricate with brilliant green or hydrogen peroxide;
Tie tightly with clothing or a bandage;
In case of accidental contact with water or other liquid, rub with a towel - just blot it gently.
It is advisable to exclude from the baby's diet foods that can cause allergies - chocolate, lemons, oranges.
What does the Mantoux reaction mean and when should mom not worry?
After three days, the doctor will evaluate the result. An impatient mom can do this on her own to cope with understandable anxiety. Several variants of the Mantoux reaction are possible.
Negative Mantoux reaction in children
The Mantoux reaction in children is considered negative if the size of the “button” is no more than 1 mm and there is no redness around it. The mother can breathe easy, the baby has an absolutely normal reaction.
Positive Mantoux test in children
How positive is the Mantoux reaction in children, in which the compaction at the injection site is from 5 to 16 millimeters. This usually indicates that after vaccination with BCG, the immune system reacts quite adequately to the danger. If the baby is not vaccinated, such a reaction may indicate that the child has a tuberculosis bacillus. Don’t panic right away; this fact does not at all indicate that the child is sick and needs to be hospitalized urgently. It’s just that Koch’s wand, under certain conditions, can become active, and then the help of a doctor will be needed. Therefore, such children need to be monitored, and, if necessary, the pediatrician will refer the child to a phthisiatrician.
Hyperergic Mantoux reaction in children
Hyperergic is a type of positive reaction. The compaction can reach 17 millimeters or more, and ulcers and ulcers appear at the injection site. The result is not very comforting - most likely, the fragile child’s body is attacked by a huge number of dangerous bacteria. The likelihood of contracting tuberculosis in this case is very high.
False-positive Mantoux test in children
A false positive can scare the mother to death, although the cause may be improper care of the injection site. However, for a more accurate diagnosis, as in the case of a positive reaction, the baby is sent to a TB specialist for consultation and additional examination.
Questionable Mantoux reaction
A reaction is considered doubtful when there is only redness of the skin or an increase in compaction up to 4 millimeters. Further annual monitoring will allow us to draw the correct conclusion. There's nothing to worry about for now.
Attention! You do not need to measure the entire reddened area, but only the “button”.
Side effects of the Mantoux test in children
As a rule, against the background of a recent illness or in the presence of allergies, an unexpected reaction to the Mantoux test may occur. Symptoms usually occur suddenly:
- high temperature, sometimes up to 40 degrees, and fever;
- skin rashes - can be not only on the arm, but also in the groin, on the butt, behind the knees, on the face;
- weakness;
- refusal to eat;
- itching in the injection area;
- vomit;
- headache.
In such a situation, it is necessary to call a doctor at home, he will examine the baby and prescribe histamines.
Mantoux reaction - do or refuse
The Mantoux reaction test is not a vaccination, so parents can refuse it if they wish. You should carefully weigh the pros and cons - after all, the health of the child depends on your choice. The risk of contracting a dangerous disease is quite real, therefore, when deciding to refuse the Mantoux reaction, try to find an alternative. Many private clinics do a special blood test - immunoglobulin AMg for tuberculosis. Of course, you will have to pay for it, but it’s still better than leaving the baby alone with a possible serious disease.
Sometimes the Mantoux test is not done for medical reasons. The doctor will refuse to perform it if the baby has:
- cough and runny nose;
- allergy;
- skin diseases;
- epilepsy;
- exacerbation of a chronic illness;
- acute infectious disease.
The Mantoux test should not be given to a child at the same time as other vaccinations, otherwise the result may be false positive.
Risk area
There are a number of conditions under which a child after a Mantoux reaction can be included in the so-called risk group for tuberculosis. This does not mean that he is sick, but the baby needs additional examination and observation by a phthisiatrician. Indications:
1. Hyperergic reaction;
2. A compaction at the injection site of 5-16 millimeters, together with a reddish mark along the lymphatic vessel or a vesicle at the injection site;
3. No decrease in Mantoux test with age;
4. The size of the “button” has increased significantly compared to last year.
Additional examination will help confirm or refute the development of tuberculosis.
Mantoux test - is there an alternative?
Some mothers have heard about the emergence of a new drug, which is supposedly a substitute for the Mantoux test. Diaskintest appeared several years ago and is successfully used in the diagnosis of tuberculosis. However, this is just an additional method of examination, and in no case replaces a long-proven method. The drug is not able to assess the effect of the immune system after vaccination with BCG, cannot suggest the need for repeated vaccination at seven years, and does not respond to bovine mycobacterium. In addition, if the Mantoux reaction is positive already at the stage of introduction of the Koch bacillus, then Diaskintest reacts only to its activation in the body and to changes in the lymph nodes and lungs. When the question is about a formidable and dangerous disease, you cannot waste precious time. Therefore, the Mantoux test is used throughout the world for mass examination.
What does Doctor Komarovsky say about the Mantoux test in children?
1. Evgeniy Komarovsky considers the Mantoux test to be the most effective method today for determining the presence of tuberculosis bacillus, which should never be neglected. He calls signs of possible infection:
- tuberculin test variation, when a negative result becomes positive without BCG vaccination;
- a hyperergic reaction, in which the size of the papule, instead of decreasing, exceeds 12 millimeters for four years in a row.
2. Dispelling the fears of many mothers about the toxic phenol content in tuberculin, he explains that this component is a natural product of human metabolism, so there is no need to be afraid of it. Moreover, its content as a preservative is so negligible that it cannot harm the baby. In order for it to really have a toxic effect, it would be necessary to give the baby a thousand Mantoux tests at the same time.
3. Regarding the alternative use of Diaskintest, Dr. Komarovsky emphasized that the Mantoux test is used all over the world as the most effective indicator. The new test does not respond to BCG vaccination, therefore, a positive reaction to its conduct indicates the presence of tuberculosis.
How can a child’s body react to the Mantoux test? Usually, after its administration, a papule appears on the skin. What should parents do if their child has a negative reaction to the Mantoux test?
What is the Mantoux test?
This is a well-known method for detecting tuberculosis. It is with its help that they check whether there is an infection in the child’s body. This procedure is carried out for the entire younger generation under 17 years of age. According to WHO, the Mantoux test is carried out in countries where an unfavorable situation with tuberculosis has developed. It is used in the following situations:
- for diagnosing children newly diagnosed with tuberculosis;
- for selecting children for BCG revaccination;
- in order to identify those infected a year ago, with an increase in infiltration of more than 6 cm;
- when tuberculosis is diagnosed.
As a result, children are selected for revaccination among the following age groups: preschool children (6-7 years old) and 14-year-old schoolchildren.
Revaccination is given only to healthy children with a negative Mantoux reaction.
Initially, the drug is administered to babies over one year old. Before this period, the sample is not injected due to the characteristics of the infant, whose body is sensitive to many irritants. Therefore, the sample result may not be accurate.
Is the drug safe?
Why does a negative Mantoux reaction occur? The test in children is the most common manipulation. This drug is considered harmless to children, but nowadays there are children who are hypersensitive to tuberculin. Therefore, the immune system cannot give the correct answer.
The drug is not related to antigens. However, some children complain of feeling unwell after its administration, while others do not remember the test.
Currently, diagnosing tuberculosis using other methods is not very informative, so it is the Mantoux test that can detect the disease in the early stages. Many children continue to live thanks to her.
How often is the test done?
The test is done no more than once a year. If the manipulation is carried out more than once every 12 months, the sensitivity of the immune system to tuberculin may increase, which will lead to an incorrect result. And if the Mantoux reaction is negative, is that good or bad? The answers to these questions are often of interest to parents of children who have this reaction.
The Mantoux sample does not need to be wetted, most parents and children know this. Under no circumstances should it be covered with a band-aid, combed or affected by other methods. If the skin is irritated, then the body may have a positive reaction to the test, which will be an inaccurate result. Therefore, a repeat procedure may be performed.
After administration of the drug, the child should limit the intake of certain foods (citrus fruits, chocolate).
If water accidentally gets into the injection site, parents should carefully blot it with a towel and report this situation to the doctor during the examination.
If the Mantoux test turns red?
If a child has a negative Mantoux reaction, then the parents believe that they should not worry. Depending on the size of the papule, the result may be as follows:
- positive;
- negative;
- doubtful;
- false positive.
Usually the specialist measures the formed lump under the skin, and not around it. Redness varies in size and does not affect the result at all. Regardless of the diameter, it is not considered a sign of TB infection.
What affects the Mantoux test?
What does this mean - the Mantoux reaction is negative? The result may be influenced by:
- allergy;
- individual characteristics of the body;
- diseases that have a chronic course;
- vaccination;
- previous infectious diseases;
- unbalanced diet;
- age less than 3 years;
- living in an environmentally unfavorable area.
When a child has a negative reaction, the following factors influence this:
- incorrect administration of the drug;
- violations during transportation and storage of the drug;
- incorrect interpretation of the result;
- low quality medical instrument.
Negative Mantoux reaction - good or bad?
If the child has a negative result, then there is no redness at the injection site or less than 1 ml. Below is a photo negative reaction Mantoux.
In some situations, such a test may be considered normal, but this does not happen in all cases. If no redness is detected, then the child’s immunity has not responded to the administration of tuberculin.
A complete lack of reaction to the Mantoux test may appear in the following cases:
- The drug that was administered during the test turned out to be spoiled during transportation, or the rules of the procedure were violated by medical personnel. Therefore, the papule is completely absent. If a child has had a negative reaction for several years, then he needs a BCG revaccination.
- Negative Mantoux reaction per year. A small number of people in the world have persistent immune system resistance to Koch's bacillus. Therefore, such a child will not develop a papule at one, two, or 14 years of age. If the parents do not have a BCG scar, then the child also falls into this number.
If the result is negative, then perhaps the body has weakened and was unable to react with tuberculin. Therefore, it is impossible to say unequivocally that this is good. This may indicate both normal health and problems in the body. Only a doctor can assess this situation based on the child’s medical history.
There are several reasons why the child’s body’s reaction will be weak:
- If tuberculosis infection occurs, the sample should be administered after another 10 days.
- The child is small, so his immune system reacts to the introduction of tuberculin in a inhibited manner.
- Unstable state of immunity (HIV-infected child), which may cause a negative reaction to the administration of the drug. In this case, increase the dose of the drug to obtain an accurate result.
Adverse reactions
Why does a negative Mantoux reaction occur? When the drug, which is intended for the Mantoux test, is correctly transported and stored, then no negative reactions should be observed in the child.
In some cases, the child becomes allergic to the drug. The causes of this condition may be related to the child’s body and the quality of the drug. In the first case, the reasons are individual characteristics and genetic predisposition to allergies. In the second case, it may be a manufacturing defect of the drug.
Along with a positive reaction, a child may experience:
- nausea and vomiting;
- high body temperature;
- general weakness;
- itchy skin.
Allergies can be caused by a previous infection. When a child has a negative reaction to a test, he needs to be shown to a doctor. If an allergy to a drug is detected, one should not refuse to diagnose the disease, because there are other methods for determining it.
Is it possible to refuse the Mantoux test?
Tuberculosis is a dangerous disease that is fatal. Infection occurs regardless of BCG placement, which is why tuberculosis diagnosis is so common among children and adults.
The Mantoux test helps to identify the disease on early stages and identify problems with the immune system. By refusing this procedure for some reason, parents are putting the child’s life in danger.
If a child has a negative reaction during Mantoux, this is in many cases considered a good result. However, doctors advise parents to undergo the necessary examination with their child and get a BCG revaccination.
If a child has inherited resistance to Koch's bacillus from his parents, then he does not have to worry about contracting a disease such as tuberculosis.
To get an accurate Mantoux test result, you need to properly care for the test site, avoiding scratching it. Before the procedure, the child must be healthy and then there will be no need to re-examine him after the result is announced.
Mantoux is an intradermal vaccination with which tuberculin is administered. Tuberculin is a mixture containing organic substances obtained from mycobacteria. The Mantoux test is performed to determine a person’s reaction to the tuberculosis pathogen antigen. This test helps to identify the absence or presence of infection in the body of a teenager and child, so it is important to know the mantoux reaction - the norm and deviations.
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Vaccination
The Mantoux test should not be carried out on the same day as other vaccinations, otherwise the risk of false reactions will increase. Vaccinations can be carried out after the test results have been established. If a routine vaccination has been carried out, the Mantoux test is done no earlier than a month after it.
Mantoux tests begin for children from one year old, annually until the age of 15, regardless of the results of last year's test.
To carry out the Mantoux test, it is prohibited to use insulin syringes and needles with an expired expiration date.
The Mantoux test is necessary for:
- identifying infected children older than one year with a non-standard reaction to tuberculin;
- identification of primary infected children;
- diagnosis of the presence of Koch bacillus in the body, but not showing symptoms of the disease at the moment;
- selection of children to be re-vaccinated against tuberculosis (carried out by assessing results at 6–7 and 14–15 years of age).
After the injection of tuberculin, a thickening of the skin is formed around the injected site.
The results of the test are assessed by the nurse who performed it or the doctor after 72 hours by measuring the “button” in millimeters with a ruler.
Mantoux reaction is normal
The so-called “button” is an area of skin that is saturated with lymphocytes sensitive to Koch’s bacillus. The more lymphocytes in the body of a child or teenager that are aware of the infection, the larger the papule will be.
The size of the papule should be measured in good lighting, transverse to the longitudinal axis of the forearm using a transparent ruler.
Mantoux reaction - the results are interpreted as follows:
- If the result is “negative”, then there is no compaction or there is a small point, like a reaction to an injection, measuring 0 - 1 mm;
- If the result is “doubtful”, there is no compaction on palpation, and the papule has a diameter of 2–4 mm with slight redness;
- If the result is “positive”:
- pronounced compaction of more than five millimeters.
- “buttons” from 5 to 9 mm in diameter are considered mildly expressed, from 10 to 14 mm – moderately pronounced, more than 16 mm – pronounced;
- compaction of more than 17 mm is considered very pronounced.
At the same time, a negative Mantoux reaction indicates that tuberculosis bacteria never entered the body. A positive Mantoux test indicates that a person has immunity against the disease. Over the course of several years, based on changes in this reaction, the doctor assesses whether a person is infected with tuberculosis.
A Mantoux reaction greater than 17 mm is called hyperergic. In addition, pustules and ulcers may form at the injection site. This reaction indicates the obvious presence of bacteria in the blood and infection with tuberculosis.
However, such a reaction can also occur in a healthy person, in a number of cases:
- has an increased tendency to allergic reactions;
- influences the phase of the menstrual cycle;
- contact with allergens: clothing, detergents;
- taking medications and other medications;
- technical errors during testing;
- recently suffered an infectious or viral disease.
An increase in the papule by 6 mm after a year is considered an increasing reaction to tuberculin.
Mantoux reaction - deviation
In some cases, a false reaction may develop, when a negative result may not be considered the norm, but a deviation:
Persons with hypersensitivity may experience an allergic reaction to the test in the form of headache, malaise and fever.
Doctors evaluate the result of the previous year, and if there is an increase in it, this is called a turn of the Mantoux tuberculin test, the criteria of which are the following indicators:
- the first appearance of a positive reaction to a test after a series of negative or doubtful ones;
- reaction more than 17 mm, regardless of how long ago the test was performed;
- a reaction of more than 12 mm that occurred 3 to 4 years after BCG;
- strengthening of the indicator by 6 mm after the previous reaction.
It is because of these changes that the doctor thinks about the possible infection of the child. For example, if every year the result was 10,10,10,10, and the last time was 16 mm, then the probability of infection is high.
Contraindications and complications
The Mantoux test is absolutely safe for both children and adolescents, since tuberculin does not affect the body or its individual systems. There is no point in doing the Mantoux test for children under 12 months of age, since depending on the characteristics of their immune system, the reaction may turn out to be false and unreliable.
It is contraindicated to perform a tuberculin test in the following conditions:
If in kindergarten or the school is quarantined for infections, the Mantoux test is performed a month after it is lifted or all symptoms disappear.
To prevent false results or complications from occurring after the test, it is necessary to properly care for the “button”:
- Do not wet the area with water;
- do not lubricate the injection site with brilliant green or peroxide;
- You cannot cover the “button” with an adhesive plaster, as the skin underneath it sweats;
- It is not recommended to comb the button.
If the “button” formed is not observed correctly, it may affect the test results. If, after evaluating the sample, a wound has formed at the site where the needle was inserted, it can be treated with any means available to you.
In most cases, the Mantoux test does not cause complications; this happens very rarely, and the child’s parents should be well informed:
- superficial ulcer more than 10 mm;
- keloid scar;
- subcutaneous cold abscess;
- regional lymphadenitis;
- osteomyelitis;
- generalized BLC is an infection.
In case of complications or possible deviations from the norm, you should consult a phthisiatrician. If all factors influencing the test results are excluded, the doctor prescribes additional examinations to most accurately diagnose tuberculosis:
- microbiological culture of sputum;
- chest fluorography;
- examination of family members.
If a child is diagnosed with tuberculosis for the first time, the risk of developing severe tuberculosis with all primary symptoms increases by 7–10%. Such children are prescribed:
- observation for a year in an anti-tuberculosis dispensary;
- three-month course of chemoprophylaxis with isoniazid;
- blood test for antibodies to HIV;
- electrocardiogram;
- tuberculin diagnostics;
- sputum examination three times a year;
- blood test for antibodies to hepatitis viruses.
At the end of preventive treatment, information about the child is transferred to the doctor with the note: “infected for more than one year.” If a year later such a child has undergone a Mantoux test and a hyperergic reaction to tuberculin has not been detected, he is observed by a doctor “on a general basis.” Such children are examined more thoroughly, and if their test result increases by 6 mm, this indicates activation of the infection.
Video
The first Mantoux test is performed on a child at 1 year of age. What should you do if your baby has a negative Mantoux reaction? Does this mean that he has not developed immunity and is re-vaccination necessary?
The Mantoux test or test is the main method of preventive examination of children for the presence of tuberculosis infection in the body. This is a kind of immunological test in which, upon intradermal administration of highly diluted tuberculin (a highly purified mixture of killed mycobacterium tuberculosis) in children vaccinated or infected with tuberculosis, a local specific allergic reaction is formed in the form of hyperemia (redness) and infiltration (thickness). In essence, the Mantoux test evaluates the “tension” of anti-tuberculosis immunity, i.e. how the baby’s body reacts to contact with tuberculosis infection. Only by the presence of a negative Mantoux reaction detected for the first time in the first year after administration BCG vaccines(BCG-M) it is quite difficult to judge whether the child has formed an immune response.
The formation, duration and stability of post-vaccination immunity are determined by a number of factors, including the biological and immunological properties of the BCG vaccine itself and the state of the immune system of the vaccinated child. The first signs of an immune response to the introduction of an anti-tuberculosis vaccine appear in the first weeks after vaccination in the form of skin changes at the site of vaccine administration: first, a small compaction forms on the surface of the skin (papule) with a diameter of 5-10 mm, over time a bubble appears in the center of the papule, then a crust. Sometimes a small ulceration with a diameter of 5-8 mm appears. Gradually, in 90-95% of vaccinated people, a superficial scar with a diameter of up to 10 mm is formed at the site of the pustule.
The quality of the vaccination performed is judged by the intensity of local changes on the skin, the presence and size of a scar. With local changes at the site of vaccine administration, an immunological restructuring occurs in the body of the vaccinated child and acquired anti-tuberculosis immunity gradually develops, which lasts for 5-7 years. Only after this period does the need for revaccination against tuberculosis arise.
In accordance with the current national calendar of preventive vaccinations, children aged 7 and 14 years who have a negative reaction to the Mantoux test are subject to revaccination against tuberculosis. The reaction is considered negative in the complete absence of infiltration (compaction), hyperemia (redness) or in the presence of a prick reaction (a prick mark up to 1 mm in size). In some cases, depending on the size of the scar formed, a positive Mantoux test may appear only 2-3 years after BCG vaccination (BCG-M). In addition, the results of tuberculin diagnostics are affected by various violations in the methodology of its implementation: the use of non-standard and low-quality instruments, errors in the technique of performing and reading the results of the Mantoux test, violation of the regime for transporting and storing tuberculin.
If a child, after vaccination, develops a superficial scar from 3 to 10 mm in diameter at the vaccination site, this indicates that the immune response to the administration of the BCG vaccine has taken place. Repeated vaccination is not provided in such cases. In the future, it is necessary to carry out the Mantoux test annually in order not to miss infection with Mycobacterium tuberculosis (“turn” tuberculin tests). At the age of 7, if there is a negative Mantoux reaction, the child must be revaccinated.
Let's start with why this sample is made and what it actually is. Tuberculin is introduced into the body and a reaction to the administration of this drug is observed. This is the only way to determine the predisposition of a child’s body to this dangerous disease. The body's reaction can be called a type of allergy. In the place where the drug was injected, redness should appear, a kind of inflammation caused by blood cells responsible for immunity at the cellular level. What does the term "positive reaction" mean? Inflammation exceeds that caused by the injection itself. The redness (papule) is measured with a ruler. The diameter determines whether the reaction is positive or Mantoux is the norm. By the way, tuberculin itself is not an antigen; it is rather an allergen.
How is the Mantoux norm assessed in children? Two to three days after administration of the drug, a specific round, reddened lump appears on the skin. The assessment is carried out after 72 hours, starting with an external examination. In this case, it is possible to establish either a lack of reaction at all or hyperemia or infiltration. It is important to distinguish hyperemia from infiltration. The thickness of the skin fold over the area of healthy skin is determined by palpation, and then at the site of drug administration. During infiltration, the skin fold thickens, as in a healthy area, in the same way. Then comes the measurement and recording of the size of the infiltrate. For this you need a millimeter transparent ruler. "Hard materials" are not acceptable for this purpose. Be sure to follow up on how the sample result will be assessed. It should be done in a bright room, only with a transparent ruler and only by a specialist! Only the size of the seal needs to be measured. Reddened skin around the lump is not a sign of immunity or infection.
Now let’s talk in more detail about what it means: “Mantoux is the norm.” The test is considered negative if the papule is completely absent and the prick reaction is from 0 to 1 mm. With such indicators, Mantoux is the norm. If the size of the infiltrate is from 2 to 4 mm, with redness and increased blood supply to the tissue, the test is considered doubtful. In cases where the infiltrate is 5 mm or more, the reaction is positive. This is a cause for alarm, but not for panic, since the test does not serve as evidence of tuberculosis. The following points indicate the danger:
- annual increase in sensitivity to the sample;
- a sharp jump with an increase of 6 mm or more;
- stay in an area of increased circulation of tuberculosis (even short-term);
- contact with a patient with tuberculosis (even short-term).
In these cases, the child should be referred to a TB specialist.
A reaction is considered weakly positive when the infiltrate size is from 5 to 9 mm;
average intensity - from 10 to 14 mm; pronounced - from 14 to 16 mm, hyperergic 17 mm and more.
U small child at two or three years of age, a positive reaction to the introduction of tuberculin may well be a post-vaccination allergy. The reaction depends on the individual’s reactivity and a year and a half after BCG can be negative, questionable, or positive (by the way, the latter is observed in 60 cases out of a hundred, according to statistics). As a post-vaccination allergy, positive reactions develop after 6 weeks, reaching particular intensity by two years, when the period of post-vaccination immunity is especially pronounced. Therefore, in the first year or two of a child’s life, reactions to the test may “show” 5-16 mm. and a BCG scar of 4 mm indicates post-vaccination immunity for up to three to four years. Mantoux is recommended for such children against the background of desensitizing agents (5 days before, 2 days after). At positive result A visit to a phthisiatrician is mandatory for the test. It is important to exclude any possible factors: infection, allergies, etc. If the reaction does become the cause of an allergy, the child is most often sent to the PTD for examination and registration. Six months later, the sample is checked. When the size of the reaction increases (or remains the same size), the allergy is considered infectious. Reduced sensitivity indicates a post-vaccination allergy.
It's good when Mantoux is the norm. But with other indicators, there is still no need to panic. As a rule, additional examinations dot the i’s, refuting the presence of tuberculosis in the child’s body.