When you can not do mantoux other questions about the tuberculin test. Is it possible to do mantoux for a cold or is it better to refuse vaccination? Is mantoux for colds a safe vaccine

Many parents are wondering if it is necessary to do a Mantoux test for a child. In many medical institutions, this method is used to find out if Koch's wand is present in the body. However, analogues of this procedure have now appeared.

How Mantou is made

Koch's wand, or tuberculosis bacillus, was discovered in 1890 by the German scientist Robert Koch.

To determine the presence or absence of a dangerous bacillus, tuberculin (microbacteria extract) is injected under the skin and waiting for a reaction. If a reaction is observed, it means that there is a tuberculosis bacillus in the body.

Why put and how often

The procedure is performed in order to detect tuberculosis at an early stage and prevent its development.

A sample is taken no more than once a year. However, there are exceptions in the form of cases when:

the child is at risk for this disease;
the child was not vaccinated against BCG tuberculosis;
there are identified peptic ulcers, diabetes mellitus, blood diseases, HIV.

The procedure is prescribed again if the reaction to the previous vaccination was positive.

The test is checked on the third day after application.

Since fluorography is not done for children, such a test is the main way to detect the early stage of tuberculosis. Early detection of the disease increases the chances of recovery.

Negative sides

In some cases, the procedure may cause allergic reactions or complications. It should be borne in mind that after BCG vaccination, this sample may show an incorrect result.

Is the procedure required?

In the event that a child is assigned to do a test, his parents or guardians sign a consent to the procedure. Without this, it is forbidden to put it.

The document states:

Name of parent or guardian;
name of the child;
consent or refusal of a parent or guardian;
the applicant's signature, transcript and date of preparation of the document.

Failure to comply with the procedure may lead to problems with the baby's departure abroad or with educational institutions. However, by law, the absence of a Mantoux test is not a reason for a child not to be allowed to kindergarten or school. At the same time, parents have the right, in case of refusal, to demand a written justification from the management.

Contraindications

The Mantoux test does not provide information about the localization of the disease, but shows the body's response to the causative agent of tuberculosis

There are also certain contraindications for the procedure.

The Mantoux test cannot be done:

when coughing;
runny or stuffy nose;
skin rashes;
exacerbations of chronic diseases;
recent vaccinations (if other vaccinations have been made, Mantoux is prescribed no earlier than 2 months later);
exacerbation of gastrointestinal diseases;
epilepsy.

In addition to the Mantoux test, there are other ways to determine the presence of diseases in the body - using laboratory tests. The choice is up to the parents or guardians. If there is a suspicion of the onset of tuberculosis, the doctor most often prescribes a set of procedures to identify the exact result.

What is a Mantoux test?
Do Mantou?
Prevention of tuberculosis

Required? This question is asked to pediatricians by many mothers. It is immediately necessary to clarify that the vaccine is called incorrectly. Is not . Its purpose is not to develop immunity against a specific pathogen, but to determine whether there are mycobacteria in the body that cause tuberculosis. Every year more and more people become ill with tuberculosis all over the world, both adults and children suffer from it. The death rate from this disease is increasing every year. Therefore, the test is very important for the early diagnosis of tuberculosis in a child.

Is it necessary to do Mantoux without fail? Is there any alternative?

The Mantoux test (tuberculin test) is a subcutaneous injection of tuberculin and a further assessment of the immune response to it. If the reaction to the administered drug is pronounced, this means that the immune system is already familiar with the causative agent of tuberculosis and reacts to it. Tuberculin is an extract of mycobacteria, which are the causative agents of tuberculosis.

The test result is usually evaluated on the third day. It is not redness that is being studied, but a thickening, a papule (the so-called button). Depending on its size, the test result may be positive, negative, false positive or doubtful. The results are evaluated, recorded in the outpatient card and the vaccination card by the pediatrician. In some cases, it is possible to refer the child to an appointment with a phthisiatrician to confirm or refute tuberculosis.

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Do Mantou?

It is usually given to children after the first year of life up to 18 years of age every 12 months. It is not advisable for young children to do it, since the results will be unreliable. Mantu is usually done in a garden, school or clinic at the place of residence.

In Soviet times, the Mantoux test was done to all children without exception. Now there are many parents who are against not only this test, but also the vaccination of the baby as a whole. There is a lot of controversy about this. However, if the child has not had a tuberculin test, there may be problems in the kindergarten or school. Is it legal?

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Prevention of tuberculosis

In accordance with the Sanitary and Epidemiological Rules SP 3.1.1295-03 (tuberculosis prevention), parents whose children test for tuberculosis gave a positive or questionable result must provide a certificate from a phthisiatrician stating that the child is healthy within a month from the date of the test. Without this certificate, the child is recommended not to be allowed into the children's team (kindergarten or school). Recommended but not required. But what about parents if they are fundamentally against the Mantoux test? There is no mention of this in the said document.

In practice, an alternative to the Mantoux test can be an x-ray of the lungs, which is recommended for children to do once every two years. Another way to avoid a sample is diaskintest.

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Which is better: Mantoux reaction or X-ray?

It is worth thinking carefully about what is more harmful to the child's body (or x-rays). It is unlikely that X-rays can become a good alternative to a sample, since X-rays are small doses of radioactive radiation, which can hardly be called useful for a growing organism. This procedure weakens the child's body, since it is more sensitive to radiation than, for example, the body of an adult. The use of radiographic examination may be justified if there are good reasons for this, for example, a suspected limb fracture. But when it becomes necessary to conduct this examination even once every 2 years, the total radiological load on the body will be excessive. This is a poor alternative to the Mantoux test.

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What is diaskintest and Pirke test?

Diaskintest involves the introduction under the skin of a solution of proteins characteristic of tuberculosis pathogens. This is a more effective test: it does not give a reaction to the BCG vaccination. It was developed in Russia and is now widely used. False-positive reactions with diaskintest are practically impossible, with the exception of cases when a person suffers from an oncological disease or is infected with HIV. In these cases, the immune system is weakened, this can adversely affect the test result.

There are certain contraindications for diaskintest:

Allergy or epilepsy.
Diseases of internal organs in the acute stage.
Infectious diseases with fever.
Recent routine vaccination of the child (more than a month must have passed from the date of vaccination).

If at least one point is present, a tuberculin test cannot be done. If the child has been sick recently, you should definitely wait a little with the test, because after the illness the body is still weakened for some time.

Over the course of several years of use, Diaskintest has established itself as completely safe. In addition, its reliability is 90%.

The Pirquet test is similar to the Mantoux test in both the technique and the interpretation of the results. The difference lies in the fact that during the Pirque test, scratches are applied to the skin without bruising. After 48 hours, the result is read.

Recently, ELISA and PCR methods have also been used in medical laboratories. Many parents are convinced that by testing the child's blood, sputum or saliva using these methods, you can get a definite answer: is the child infected with mycobacteria or not. This is not entirely true. These methods are not effective when the infection of the body has occurred quite recently, they are not able to reflect the activity of tuberculosis pathogens.

The Mantoux reaction is widely used in medicine to determine if a person is infected with tuberculosis. Injections are carried out mainly in childhood, starting from 12 months. Therefore, many parents are interested in what the Mantoux vaccination is for and how safe it is.

What is the Mantoux norm for a child and an adult?

Many are interested in what size Mantoux should be. The severity of the immune response depends on the age group of the child, the time of vaccination against tuberculosis. The normal Mantoux reaction in a child at 12 months is a papule of 10-17 mm.

There are the following norms of tuberculin diagnostics:

Children 2-6 years old, papule does not exceed 10 mm;
Children at the age of 6-7 years are characterized by the occurrence of a negative or questionable immune response.
Children 7-10 years old, the size of the papule normally reaches 16 mm if the child was given the BCG vaccine;
Children aged 11-13 are characterized by the extinction of the immune response, so the "button" does not exceed 10 mm;
Children 13-14 years old, there is a negative or doubtful reaction. Revaccination required.

In adults, the Mantoux test should normally be negative. There may be slight redness and the development of papules no more than 4 mm in diameter.

What are the test results?

2-3 days after the tuberculin injection, the doctor should evaluate the results. With a normal Mantoux reaction, a small dot is barely noticeable on the arm (occurs only in rare cases in modern children) or a red spot has appeared.

Depending on the local reaction, the result may be:

Negative. The complete absence of inflammation at the injection site of tuberculin indicates the absence of contact with Mycobacterium tuberculosis. It may also indicate long-term contact with the causative agent of tuberculosis, when the body has successfully overcome the infection;
positive. At the injection site, inflammation and a small induration appear - a papule. To assess the body's immune response, it is the formed “button” that is changed. A positive Mantoux reaction can occur when a child is infected with tuberculosis or as a result of the introduction of the BCG vaccine. At the same time, a mild reaction is distinguished, when the size of the papule does not exceed 9 mm, the average one is not more than 14 mm, and the pronounced one is 15-16 mm. It is possible to develop a hyperergic reaction when the "button" exceeds 17 mm in diameter. This condition is accompanied by the development of abscesses, tissue necrosis, an increase in nearby lymph nodes;
Doubtful. The Mantoux test is considered doubtful if redness occurs without the formation of a papule. In such cases, hyperemia usually does not exceed 4 mm. This result is regarded as the absence of tuberculosis.

Sample Features

As part of the Mantoux reaction, tuberculin is administered subcutaneously to children. It is a mixture of extracts of heat-killed cultures of mycobacteria M. tuberculosis and M. bovis. After the injection, lymphocytes are brought into the injection site with the blood flow, their accumulation provokes reddening of the skin and the appearance of a seal.

Medical staff assesses whether the body has met the causative agent of tuberculosis by how intense the reaction to the Mantoux test is. In the absence of an immune response in a child, a subsequent vaccination against tuberculosis is required.

Important! The Mantoux reaction allows you to evaluate the dynamics of the immune response in children.

It is highly likely that the development of tuberculosis is possible in the presence of a "turn". It suggests a sharp increase in the size of the papule (more than 6 mm) compared with the test carried out last year. Tuberculosis can also be suspected with a sudden change in a negative reaction to a positive one without vaccination or a persistent large papule for 3-4 years (more than 16 mm). With the above results, the child is sent to the TB dispensary.

How is the vaccination done?

The Mantoux reaction is carried out in a sitting position using a special tuberculin syringe. The drug is injected subcutaneously, the injection site is the middle third of the surface of the forearm. The Mantoux test involves the introduction of an exact dosage - 0.1 ml, because the substance contains tuberculosis units. After the injection, a small papule appears on the skin, which is popularly called the "button".

The Mantoux reaction in children is carried out taking into account the following requirements:

The child cannot be vaccinated 3-6 months before the test;
The needle should be inserted with the cut up, slightly pulling the skin. This allows you to enter the drug into the thickness of the epithelium;
Vaccination should be carried out only with a tuberculin syringe.

Who is being tested?

Mantoux vaccination is given to children annually. The first injection is carried out at 12 months, when the child's immune system is sufficiently formed. The Mantoux test is performed for children under 16 years of age. However, in some cases, injections continue until the age of 18, which is associated with the incidence of tuberculosis in a particular region or the individual reaction of the body.

In adults, tuberculin diagnosis is not carried out. During the diagnosis of tuberculosis, other available methods are used:

X-ray or fluorography of the chest;
Sputum examination for the presence of Mycobacterium tuberculosis;
If necessary, appoint computed tomography;
Additionally, a detailed blood test is carried out.

Adults have not been vaccinated with BCG since adolescence. Therefore, the Mantoux test is a highly sensitive and reliable method for diagnosing tuberculosis.

How often can you do Mantoux?

Usually the Mantoux test is performed annually. However, with the development of a positive reaction to tuberculin diagnosis, the injection is repeated. In such cases, the Mantoux reaction in the child is carried out again after 2-3 weeks. Upon receipt of a positive result, the patient is referred to a phthisiatrician for an in-depth diagnosis.

Important! The Mantoux reaction should not be carried out more than 3 times during the year.

The Mantoux test causes conflicting opinions among pediatricians. Some experts consider the Mantoux reaction to be harmful to a growing organism. This is due to some substances that are part of the administered drug. Twin-80 may be dangerous. The substance is used as a stabilizer. Tween-80 in the human body can provoke an increase in estrogen levels, which causes an imbalance of hormones. The compound can lead to early puberty, a decrease in sexual function in men.

Phenol is also part of the Mantoux reaction. The substance is a cellular poison. The danger lies in the fact that the ability of the compound to accumulate in the body has not been refuted. Therefore, with repeated Mantoux reaction in children, an overdose of phenol is possible. The condition leads to the development of seizures, impaired functionality of the kidneys and liver.

Some pediatricians believe that the Mantoux test has the following disadvantages:

Unreliability of results. The Mantoux reaction can give false negative and false positive results. A similar situation is increasingly observed in modern children;
cytogenetic disorders. Mantoux vaccination in rare cases leads to various damage to the genetic apparatus. Experts attribute this to the influence of tuberculin, which is a strong allergen;
Pathologies of the reproductive system. According to animal studies, phenol and Tween-80 can lead to the development of pathological processes in the genitals;
development of an allergic reaction. The appearance of a "button" may be the result of an allergy to the administered drug. With individual hypersensitivity to the components of the sample, anaphylactic shock may develop;
Idiopathic thrombocytopenic purpura. In rare cases, the Mantoux test provokes a sharp decrease in the level of platelets, which provokes the development of a dangerous disease. This fatal pathology leads to the development of hemorrhage in the brain.

However, most pediatricians believe that the injection does not stress the child's immune system. Therefore, the annual Mantoux vaccination is absolutely safe for the child's body. The main claims are made to phenol, which is part of the drug. However, its amount in the sample does not exceed 0.00025 g, so the toxic compound does not adversely affect health.

How to care for a vaccine?

False-positive or false-negative reactions to Mantoux usually occur when the tuberculin injection site is mishandled. Therefore, to ensure the reliability of the result, the following rules should be followed:

Do not treat the injection site with hydrogen peroxide, cream;
Contact of the papule with any liquid should be avoided;
The injection site does not need to be sealed with a plaster, because this provokes increased sweating;
It is necessary to ensure that the child does not comb the papule;
To prevent the development of an allergic reaction, it is recommended to temporarily exclude chocolate, citrus fruits, tomatoes, and sweets from the diet.

If the child accidentally wets the hand where the Mantoux test is injected, then it is enough to gently blot the injection site with a towel. It is imperative to inform health care providers of the incident during the evaluation of the results.

What can affect the test result?

The Mantoux reaction in children is not 100% reliable. More than 50 different factors can affect the severity of the immune response. It is worth considering in more detail the most common causes of a false result:

The Mantoux test is essentially a diagnostic test of the body. However, there are a number of limitations to the study:

Various skin diseases in history;
Various infectious diseases in acute and chronic form. Vaccination is recommended to be postponed until the symptoms disappear completely;
Development of allergic reactions;
epileptic seizures.

Possible adverse reactions

The Mantoux test is usually well tolerated. However, the following conditions may develop:

Necrotic changes in the skin and inflammation in the area of administration of the drug due to a hyperergic reaction of the body;
The occurrence of an allergic reaction. In this case, the test becomes ineffective, because doctors will not be able to determine the immune response of the child's body to the introduction of tuberculin.

Allergy symptoms develop suddenly, similar to a viral infection: fever, itching, skin rashes, loss of appetite, anaphylaxis (severe allergic reaction), decreased performance and lethargy of the patient.

There are the following reasons for the development of complications after the introduction of tuberculin:

Testing for patients who have contraindications;
Violation of the rules for the introduction of tuberculin;
In case of violation of the transportation or storage of the drug;
Use of poor-quality vaccine;
Individual characteristics of the organism.

Proper nutrition of the child will help reduce the risk of adverse reactions. He must receive a sufficient amount of vitamins, nutrients, trace elements daily. The child's diet should include protein foods, fresh fruits and vegetables.

Alternative diagnostic methods

If a child has a congenital hypersensitivity to any component of the drug that is administered as part of the Mantoux test, then the use of alternative methods is recommended. The immunogram and the Suslov test are widely used. Both methods are based on taking blood from a vein, followed by determining the reaction of blood cells.

An immunogram is used to determine the number of cells that the body can produce to fight pathogenic agents. This allows the doctor to assess the state of the child's immune system, the ability to resist infections. However, the method does not reliably determine whether a child is infected with tuberculosis.

Suslov's technique involves the study of blood after the introduction of tuberculin into it. A laboratory assistant examines the emerging pattern of lymphocytes under a microscope. This method allows you to determine whether a child has tuberculosis. However, the reliability of the sample does not exceed 50%.

That is why alternative methods are not widely used. After all, as part of the Mantoux test, the phthisiatrician receives more reliable and complete information about the patient's condition.

Tuberculin diagnosis helps doctors assess how a child is able to resist mycobacteria. The Mantoux test is not a vaccination, it is carried out solely to determine the presence of the causative agent of tuberculosis in the body.

The tuberculin reaction, also known as Mantoux, is a procedure surrounded by a lot of speculation and outdated information. Let's figure out what can and cannot be done after the mantoux reaction, who should not do it and dispel the fears and delusions of parents.

What is Mantu?

This method is needed in order to identify whether the child is infected with a tuberculosis infection. In fact, this is an immunological test, but not a vaccination. But it is needed precisely in order to select those children who need repeated BCG vaccinations. The first of them is done immediately after birth, and the need for the next vaccination is determined precisely with the help of this test. To determine the presence of Koch's sticks, the causative agent of tuberculosis is injected under the skin of the child, however, destroyed. A few days after this procedure, the medical worker must assess the size of the formed papule (the same “button”) and draw their own conclusions. Remember that if all other vaccinations for a child are contraindicated, then Mantoux can still be carried out.

Typically, such tests are carried out before the age of 14-15, but can also be done at an older age. So, when at the age of 14 the “button” after Mantoux increased sharply compared to the result at 13 years old, Mantoux can be carried out until the age of 17-18.

If the papule is too big, is it definitely tuberculosis?

In theory, the increased size of the seal indicates a strong reaction of the immune system and its tension with respect to the tubercle bacillus, a positive result does not always indicate a tendency to the disease or that the child is already ill.

It can be positive after a recent BCG vaccination (and indeed, any other vaccination), after a recent infectious disease, with a tendency to allergies, etc. That is why mantu is done to the child annually. It is important here that in a year the papule does not increase by several millimeters at once. If there was a so-called mantoux turn, you can already think about it.

Since Mantoux is not an accurate indicator of the presence of tuberculosis, the child and his relatives, in case of a turn, need to undergo other studies, including sputum culture and fluorography. Only then can a diagnosis be made and anti-tuberculosis drugs prescribed. You may also be concerned about the following:

If sensitivity to tuberculin (and papule) grows at least a little, but every year;
if the child has been in contact (even if not for long) with a subject who suffers from an open form of tuberculosis;
if one of the family members suffered from this disease;
if the child had to visit an area that is unfavorable for tuberculosis.

By the way, even being infected does not mean the presence of tuberculosis at all: a tenth of those who have tuberculous mycobacteria are found to fall ill. If timely prophylaxis with anti-tuberculosis antibiotics is carried out, then the risk of getting sick becomes negligible.

Tip: Mantu is recommended for every child, because parents do not know when he will have to contact an infected person. In addition, in many institutions, including children's, people with fake health books who have not undergone fluorography for a long time can work, and there is a risk of infection. And a son or daughter can walk in the same company with infected children ...

When and who can not do mantu?

Doctors say that Mantoux is harmless, so you can do it even for a child who has chronic diseases of the internal organs, and Mantoux will not harm a healthy child.

Tuberculin does not contain mycobacterium tuberculosis, it is not injected too deeply, so mantoux is not dangerous. But in some cases it cannot be done:

Under the age of one year;
with skin diseases;
if less than one month has passed since any vaccination;
with a tendency to epilepsy;
during severe allergies;
during quarantine;
with an exacerbation of any disease, whether it is infectious or non-infectious;

Mantoux can be done a month after any of these reasons have disappeared.

What can and cannot be done after vaccination?

Many mothers are wondering what to do if the child wets the papules, when can you walk, etc.

Everything that happens after Mantou is not as scary as many people think. Walking after this test is quite possible. It is better to go for a walk after vaccination and it is not worth getting cold (due to the fact that the “behavior” of immunity can be unpredictable), but the tuberculin test, as previously mentioned, is not a vaccination.

The opinion is also popular that after this test it is impossible to wet the injection site and many perceive this as a dogma. In fact, after mantoux, you can swim, and go to the pool, and generally engage in any water procedures. This belief arose at a time when the tuberculin test was carried out using the Pirquet test and other skin tests, in which tuberculin was administered by scratching the skin. Today, tuberculin with destroyed bacteria is injected deep under the skin, so it doesn’t matter whether this place was wetted or not, it’s just that doctors have an installation from the past. But what you can’t do with a papule is scratch it and rub it with a washcloth. Also, you can not glue a patch on it and smear it with brilliant green or peroxide. Of course, in no case should a tuberculin test be performed on the day of the vaccination: it is not known how the immune system will react to this. It is forbidden to drink antihistamines before the test itself. You should not do a test if the child coughs: a cough is a reaction to a cold and an allergy, which means that the result of the test will most likely be incorrect.

It is important to know: if after the test there was blood at the place of its conduct, the result will be incorrect. But a new test can be carried out only after a year.

How to care for a tuberculin test? Special care for her is not needed, the main thing is not to touch the papule. If it gets very wet, it is enough to wipe the “button” with a soft cloth, and if an abscess appears or the papule is injured, with the permission of the doctor, you can treat it like an ordinary wound. In addition, after the test, before it and on the day of the test, it is better for the child not to give the food to which he was allergic, as well as any citrus fruits.

What not to do with mantoux - advice and recommendations from experts What methods will help reduce the Mantoux reaction? The consequences of various kinds of vaccinations Mantoux test: why should a child do it, is it dangerous? If there are no contraindications, the mantoux test is the best test for tuberculosis
An alternative to mantou for children at different ages
Mantoux - sample sizes and their standard values

Tuberculosis is a deadly infectious disease. At the beginning of the third millennium, the CIS countries were on the verge of epidemics.

The state prevention program, based on the best traditions of Soviet medicine, helped to bring the situation under control.

Every newborn in the maternity hospital is vaccinated with BCG. She gives the opportunity create immunity against tuberculosis from the first days of life, when children are especially vulnerable.

The Mantoux test is included in the program as a means of monitoring efficiency vaccination, as well as a way early diagnosis. Having made BCG, it is pointless to refuse the annual Mantoux test: both events are parts of a single, evidence-based preventive and diagnostic complex.

Is it necessary to do a Mantoux test for a child?

BCG is a serious, but necessary load for immunity. With Mantoux, the dose of the administered drug is negligible, the body reacts to it in much the same way as to a mosquito bite. At the same time, a small “button” solves two problems at once: it reveals whether the child has protection and how strong, and allows you to detect infection if it happened during a year.

The sooner the infection is detected, the greater the chance for a complete cure. By refusing one of the planned Mantoux checks, parents deprive the child of the guarantees of early diagnosis for the whole year. During such a period in the child's body (especially in the first two years in babies and during hormonal changes in adolescents), infection can develop into disease, which will take years to heal.

How is the procedure carried out

When checking Mantoux, crushed tissue fragments of dead bacteria of the pathogen are introduced into the body. They are thermally and chemically processed and do not pose any health hazard.

Photo 1. When injected, a so-called "button" is formed on the skin.

An aqueous solution of the tuberculin preparation is injected under the top layer of the skin with a special syringe. One test - 0.1 mg tuberculin. Phenol is used as a preservative, but its amount is several times less than that excreted by the kidneys every day as a waste product of the organism itself.

Result interpretation

After 72 hours at the next appointment, specialists measure the reaction and decipher the result. The reaction is manifested by two main signs, redness (hyperemia) and thickening of tissues, swelling around the injection site, and the appearance of an infiltrate. Such a reaction is called papule.

What does the Mantoux result in adults show

Why does the human body react to tuberculin? The body of a healthy, unvaccinated adult or adolescent over 15 years old does not really respond to it. The normal Mantoux reaction in this case is negative, that is, complete no trace on the skin of the forearm at the injection site. The diagnostic result in this case is clear and accurate.

Photo 2. For an adult, a normal reaction is the absence of traces, there should be no redness.

The method is used in a polyclinic or a specialized medical institution when dealing with complaints of symptoms similar to those of infection, or after contact with a carrier of an open form of tuberculosis. Even a dubious reaction (redness and slight swelling) will arouse suspicion and will be the subject of further research..

Types of reactions in children

The principle of decoding the Mantoux reaction in children is different. After BCG vaccination in the child's body, serious work begins to create immunity. By the end of the first year of life, the scar after vaccination is completely formed. Its size is an important indicator when checking Mantoux. The opinion that a small scar speaks of good immunity is erroneous.

It is a large scar ( about 8 mm) will provide the child protection up to the second vaccination in primary school, i.e. until the age of seven. The result of the Mantoux test will be quite pronounced.

The appearance of a papule after Mantoux (positive reaction) in vaccinated children and adolescents indicates that protective antibodies have gathered around the injection site.

If the last check was not carried out for some reason, the child is considered ill not for a year, but for two years or more. In childhood and adolescence, the development of the disease is rapid, the course of treatment will be longer and more serious.

The first Mantoux test is performed on a child aged one year. Normal papule size from 5 to 10 mm. With a large scar, the result is 10 mm.

Second check - at two years old. At this age, the stress of immunity is maximum, the allowable size of the papule, 15-16 mm, approaches the value beyond which the reaction will be recognized as hyperergic or too pronounced (in children, this threshold 17 mm).

Let's say before the second test the child just played in the sandbox. Dirt and sweat got on the papule, irritation appeared. The child began to scratch the "button" - it turned red and increased.

Instead of 15-16 pediatrician wrote: 18 mm and sent the parents with the child to TB dispensary.

The phthisiatrician conducted an additional examination. His conclusion is a "false positive reaction" caused by extraneous causes. The fact of infection was not confirmed. The emotional reaction of the parents is to refuse further checks.

Children's immunity in later years declining, the papule becomes smaller every year in all healthy children. Before school, most children show a negative or dubious reaction. The presence of data on the results of the Mantoux test for future first graders is mandatory (or very desirable). Parents agree to test. Result - 4-5 mm a positive reaction is possible.

If the reports on past samples were present and showed the correct dynamics (decrease from year to year), the pediatrician most likely would not have any questions. Now he is obliged to send the child to the TB dispensary. An additional examination will be carried out at the busiest time - before entering the first grade. This will take into account the possibility of infection. for several years.

Tuberculosis tests instead of Mantoux

Reference! If you refuse Mantoux (for example, an allergy to tuberculin components), other diagnostic methods are used.

Diaskintest excludes most false positive reactions, contraindications for its use are the same as for Mantoux. Quantiferon test it is more expensive, but it can be carried out even with illness. The results of these tests are accepted by schools and kindergartens instead of Mantoux.

Fluorography replaces the Mantoux test with a mandatory medical examination in adults. Its negative result indicates the absence of signs of disease in the lungs, while the Mantoux test helps to diagnose all forms of tuberculosis.

Do diseases (for example, a runny nose) affect the reaction

The result of the Mantoux test is influenced by extraneous factors that are not related to infection with tuberculosis. The fact of infection is established in one out of a hundred cases, false-positive reactions are noted much more often.

It is worth preparing properly for the test, and not abandoning it in advance.

Seeing a pediatrician or therapist obligatory before the Mantoux test. If the patient's state of health raises concerns, the doctor will provide him with a "medical tap" and reschedule the procedure to a more convenient time.

The test is not performed at high temperature, with any disease in the acute stage, with indigestion, skin diseases, runny nose (snot) and cough, nervous diseases (epilepsy), asthma.

The doctor clarifies what allergic reactions are possible in the patient, if necessary prescribes antihistamines.

The best time for annual Mantoux checks is indicated in the vaccination schedule. It is not always possible to observe it: the test cannot be carried out earlier than in a month after another vaccination, after illness or quarantine.
The question of whether to submit additional tests before Mantoux, decided by the doctor. If it is necessary to confirm that the patient is healthy, that immunity has recovered after the illness, if additional grounds for medical withdrawal are required, such tests are carried out.
Preparation for the procedure requires increased attention. A week before the test, take care of a healthy diet, eliminate allergens(chocolate, citrus fruits), semi-finished products, carbonated drinks. Compliance with the diet is important even after the procedure until the examination and interpretation of the result.
Try to disease did not occur on the eve of the procedure and after it. Do not overcool, do not overwork, avoid large crowds.
Before the procedure, explain to the children that the “button” should not be disturbed, rubbed or scratched. After the test, make sure that sweat, dirt, lint from clothing, and animal hair do not get into the wound. Do not handle Mantoux medicines, including iodine and brilliant green. Do not use a patch.
The combination of hazards such as overheating, sweat and revealing clothing makes it especially important to pay close attention to the Mantoux. in summer time. The reaction of the body to tuberculin does not depend on the time of year, therefore, if necessary, the procedure is prescribed in the summer.

If the patient himself and his relatives take the preparation of the Mantoux test seriously, if there is enough information about the importance of the procedure and its features, checking the Mantoux reaction will not take much effort and time, there is no reason to refuse it.