A method of analyzing the reaction of the human body to the introduction of the causative agent of tuberculosis into it is a Mantoux test or a tuberculin test. It is named after the French doctor, who was the first to propose subcutaneous administration of tuberculin. What can be learned with such a test? It shows if the child is sick with tuberculosis.
Mantoux test - nothing to fear
To date, the following topics for parents are relevant: Mantoux test, assessment of the result in children. Photos that are found in open sources often amaze the imagination and create wide scope for parental fears. After watching them and reading the information on the Internet, many parents simply refuse to give this vaccine to their children. Although in fact, the Mantoux reaction does not apply to vaccinations. With its help, you can find out whether there is a tubercle bacillus in the body and at what stage the disease is, if the diagnosis is still confirmed. The main task of vaccination is to identify the early stages of the disease. If the assessment of the result of the Mantoux test in children is negative, then BCG is put.
The very first Mantoux vaccine is given in a one-year return. Up to a year, the reaction is not revealed due to age-related characteristics of the development of the baby's body.
Babies have very sensitive skin. The result may turn out to be unreliable, but they determine it according to some standards that indicate how the Mantoux vaccine should look. At 4 months, doing it is also impractical. An important role in the reaction of the sample is played by the balanced nutrition of the child. Therefore, you should carefully monitor his diet.
Mantoux vaccination is done every year, once. For 14 years, children need to undergo this test strictly on schedule, because only in dynamics can you see the presence of a disease or identify a predisposition to it.
First time
The first test put to the child at the age of 12 months. Scientists have proven that previously such a procedure as the Mantoux test was pointless. Evaluation of the result in children of 1 year is informative, but in children who have not reached this age, the reaction is often false negative.
However, many doctors argue that if the child was not vaccinated against tuberculosis according to the calendar - in the first days after the birthday, then the test should be set twice, starting at the age of six months.
What can affect the “button”?
They put the Mantoux vaccine in the hand, on its inner side, between the elbow and wrist. In addition to the fact that Mantoux cannot be scratched and soaked for three days, it is also not recommended to glue it with a band-aid, rub it hard, pinch it with things, cause any other irritation on the skin. If you do not follow these simple rules, a false-positive result may form, in which case you will have to undergo an examination.
Mantoux test: assessment of the result in children
The photo below shows that the reaction is very pronounced. In this case, the size of the papule reaches more than 1.5 cm in diameter. How else is the result evaluated?
- A pronounced Mantoux reaction is observed with a papule size of 15-16 mm in diameter.
- The reaction to the sample will be of medium intensity when the diameter is 10-14 mm.
- Weakly positive reaction - if the diameter of the seal is 5-9 mm.
- A positive reaction is observed if the size of the papule reaches 5 mm.
- A reaction is called doubtful if the button has a size of 2 to 4 mm. This also includes cases if the Mantoux test site has redness of any size, but there is no seal - the so-called “buttons”.
- Negative Mantoux test - with a seal size of 0 to 1 mm.
Parents should not panic ahead of time if the “button” is suspicious after the injection, because the result on the third day may differ from what the Mantoux vaccine should look like on the first day.
We reduce risks
During the diagnosis period, all products from which allergies can begin should be excluded from the diet. These are primarily chocolate, oranges, tangerines and other citrus fruits.
If suddenly the child wet Mantu, you should wipe the skin with a soft cloth, towel or napkin, without effort. Subsequently, it is necessary to inform the doctor during the examination. The “button” must be closely monitored so that the assessment of the result of the Mantoux test is reliable.
And if severe redness occurs?
If after the test was delivered, the injection site turned red, then do not panic. After three days, the doctor will pay attention not to this symptom, but to the seal - the papule.
Severe redness is not considered the result of a positive reaction and an indicator of the presence of tuberculosis in the child.
The doctor can measure the place of redness and record the result if there is no “button” at the injection site.
Measure yourself
If desired, parents can independently determine the result at home seventy-two hours after the injection, but some still have the question of how the Mantoux vaccination should look negative. If, after the specified time after injection, the resulting seal does not exceed 1 mm in diameter and redness is not observed, then the result is negative. Everything is in order, you can breathe a sigh of relief. A dubious result is produced by a “button” that does not exceed 4 mm, or the appearance of only redness. Education, the size of which exceeds the norm (from 5 mm - 16 mm), is a positive answer. A positive result can also mean a hyperergic reaction, ulcers or pustules at the injection site, the formation of a seal larger than 17 mm.
It is better to know what the Mantoux vaccine should look like on day 3. The photo below is the norm.
If the reaction is not happy
A false positive reaction occurs when the Mantoux “button” is mistreated. In this case, the child is sent for examination with the parents to the TB dispensary. They will take all the necessary tests, and the TB doctor will explain the situation. Often they also offer to donate blood - this test is called PCR (polymerase chain reaction). It is used for false positive reactions that the Mantoux test gives.
Evaluation of the result in ordinary cases is based on annual dynamics. The size of the papule should decrease by a few millimeters per year, and at the age of seven years in a child it should be almost invisible.
What else is important?
Do not panic if the child is sent to a TB dispensary. A positive reaction may indicate that the baby is a carrier of the stick, but it is not contagious. He can attend school, kindergarten. Such sticks are not transmitted through the blood. People are infected only from a person with tuberculosis, by airborne droplets.
However, when the assessment of the result of the Mantoux test is positive, the child should be monitored by a TB doctor. But if the specialist makes an appropriate diagnosis, then the small patient will have to undergo treatment.
First of all, he will be sent for chest x-ray and sputum microbiological examination. In addition, all family members will also need to be screened.
Phenol and allergies - what is the relationship?
Children sometimes experience allergic reactions to the Mantoux vaccine. The reason for this is individual intolerance to the components of the drug or a hereditary predisposition. Often the cause of allergies is phenol, which is part of the vaccine. This substance is toxic, but in small doses does not harm. There are times when a child has phenol intolerance, then allergic reactions occur. In any case, it is necessary to consult a specialist when an allergic reaction of the body gave a Mantoux test.
Evaluation of the result after some time should not be accompanied by the following allergy symptoms:
- loss of appetite;
- skin rash;
- high fever;
- weakness
- anaphylaxis.
In this case, you can safely put the sample next time. But you need to remember that allergies can occur anywhere on the child’s body: in the groin, under the knees, on the inside of the elbow and, of course, in the place where the Mantoux test is placed. Evaluation of the result, entailing even the slightest symptoms of an allergy in a child, forces parents to immediately consult a doctor. He will prescribe antihistamines to relieve allergy symptoms. Often, side effects on Mantoux arise due to recent illnesses, and can be accompanied by various ailments.
If the child has skin diseases, chronic infectious diseases, especially in the acute stage, is allergic to something, epilepsy or a cold, then you can not give the Mantoux vaccine. It is worth postponing this event and holding it after a month after the disappearance of all symptoms. Any vaccinations weaken the immune system, so they should be given at different times. Otherwise, the evaluation of the result of the Mantoux test may turn out to be false positive.
Rejection of Mantoux
Parents can opt out of the Mantoux vaccine by law. She is voluntary. You can refuse by writing a statement in the clinic. This should be done with 100% certainty that the child has never had contact with a patient with tuberculosis.
Mantoux test weakens the child’s immunity, like any other vaccine. To avoid this, you can use an alternative method and donate blood from a finger. The only minus of such an analysis is that it is carried out only in private clinics for a fee.
Mantoux test: evaluation of the result in adults
The photos presented above illustrate well what should be the reaction to Mantoux in children. In adults, it is practically no different.
Mantoux is an immunological test that indicates the presence of tubercle bacillus in the body.
After the introduction of the drug, which contains tuberculin, a reaction occurs. With its help, you can find out whether a person is sick. At the injection site, inflammation is caused by the blood cells responsible for the immune system. Lymphocytes are attracted from nearby blood vessels of the skin using microbial fragments. But not all lymphocytes are attracted, but only those that were already familiar with Koch's wand before.
If a person is infected with a bacterium, then the inflammation will be great, the result will be positive, but if the possibility of infection was earlier, but it did not happen, then the reaction will be with severe, but not intense irritation. Of course, from a positive reaction it follows that the plaque did not arise due to the injection itself and possible skin irritation due to it, but because a certain reaction occurred.
Operating principle
After the introduction of tuberculin, a certain allergic reaction occurs. And on the second or third day, a seal appears on the skin, where the Mantoux test was delivered. Evaluation of the result (how the “button” should look) will be reliable only when all the rules for caring for the injection site are followed.
Usually it has a convex, rising above the general level of the skin swelling, often reddened and dense to the touch. The more immune cells in the human body that encounter a tuberculosis bacillus, the more pronounced and large the compaction.
Mantoux test in adults
In adults, the reaction to Mantoux is of three types:
- negative
- false positive;
- positive.
A negative test is diagnosed in the case of a complete absence of a “button”, or if it has a size of up to 1 mm. Such a result is considered the norm. When the size of the plaque is from two to four millimeters, its redness, the result is dubious and can be considered false positive. With a plaque size of more than five millimeters, the reaction is positive. When the diameter of the seal at the injection site in adults is more than 21 mm, the reaction is hyperergic.
So, the Mantoux vaccination should be carried out every year in order to identify negative dynamics or possible infection. For example, for three consecutive years, plaque sizes were recorded within 14 mm, and in the fourth it increased to 20 mm. There is a high probability of infection. It is the turn of the Mantoux tuberculin test that pushes the phthisiatrician to prescribe additional examinations to the potential patient.
If the conducted Mantoux test is alarming
Evaluation of the result (the photo has already been presented above), which is doubtful, should occur objectively. After all, there is still the likelihood of an allergic reaction to the Mantoux test, and recently transferred infections or already existing intolerance to any substances may also affect. In these cases, the reaction can show a positive result, therefore, any factor that negatively affects the Mantoux test should be reported to the doctor. Subject to all the rules, the result will be the most reliable.
Evaluation of the result: what pay attention
After 72 hours, you must consult a doctor, where a Mantoux test will be examined. Evaluation of the result, the photo of which is located below, indicates that there are no problems. But the entire examination begins from the place of introduction of the vaccine. In this case, you can set three states:
- hyperemia;
- infiltrate;
- lack of reaction.
It is very important to distinguish hyperemia from infiltrate. To do this, probe the "button", and then a healthy area of the skin to determine the thickness of the seal. If the reaction is an infiltrate, then the density of the skin in a healthy area and at the injection site will be different. With hyperemia, the skin density is the same.
Next, you need to measure the plaque using a transparent millimeter ruler. Measure the transverse, relative to the axis of the arm, size of the infiltrate and register it. Performing these manipulations in a poorly lit room using improvised means replacing the ruler is strictly prohibited. Only the seal size is subject to measurement. If only redness occurs at the injection site, and the papule is absent, then it is recorded, but there is no reason to believe that a positive reaction has been detected in a person.
This is how the negative reaction to the Mantoux test looks like.
What do patients say?
Recently, the number of people opposed to having their children given a Mantoux test has increased. Evaluation of the result, feedback from parents about the procedure itself is quite categorical. In most cases, the negative mood of adults against Mantoux is that after it, children are sent to TB doctors. In fact, it turns out that the alarm is false, and the “button” has become inflamed for reasons completely unrelated to tuberculosis.
But it is worth remembering that it is still necessary to take tests. If you do not like the Mantoux test, there are alternative methods for determining tuberculosis cells in the human body.