The way to analyze the reaction of the human body to the introduction of the causative agent of tuberculosis into it is the Mantoux test or the tuberculin test. It is named after the French doctor who first proposed the subcutaneous administration of tuberculin. What can be learned from such a test? It shows if the child has TB.
Mantoux test - nothing to be afraid of
Today, the following topics for parents are topical: Mantoux test, evaluation of the result in children. Photos that are found in open sources often amaze the imagination and create a wide scope for parental fears. After looking at them and reading 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 if 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 detect the early stages of the disease. If the evaluation of the Mantoux test result in children is negative, then BCG is placed.
The very first Mantoux vaccination is done at a one-year-oldreturn. Up to a year, the reaction is not detected 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 it is determined according to some standards that indicate how the Mantoux vaccination should look like. At 4 months, it is also impractical to do it. An important role in the reaction of the test is played by a balanced diet 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 according to the schedule, because only in the dynamics can you see the presence of the disease or identify a predisposition to it.
First time
The first test is given to a child at the age of 12 months. Scientists have proven that previously such a procedure as the Mantoux test was meaningless. The evaluation of the result in children of 1 year old is informative, but in babies 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 given twice, starting from the age of six months.
What can affect the "button"?
Put a Mantoux inoculation in the arm, on its inner side, between the elbow and the wrist. In addition to the fact that Mantu cannot be scratched and wet for three days, it is also highly recommended not to stick it with a plaster, rub it hard, pinch it with things, or cause any other irritation on the skin. If you do not follow these simple rules, a false positive may form.result, in which case you will have to undergo an examination.
Mantoux test: evaluation of results 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?
- Severe Mantoux reaction is observed when the papule size is 15-16 mm in diameter.
- Reaction to the sample will be of medium intensity when the diameter is 10-14mm.
- Slightly positive reaction - if seal diameter is 5-9mm.
- A positive reaction is observed when 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 "button".
- Negative Mantoux test - with seal size from 0 to 1 mm.
Parents should not panic ahead of time if after the injection the "button" has a suspicious size, because the result on the third day may differ from what the Mantoux vaccine should look like on the first day.
Reducing risks
During the diagnosis period, all foods that may cause an allergy should be excluded from the diet. This is primarily chocolate, oranges, tangerines and other citrus fruits.
If suddenly the child wets the Mantoux, you should wipe the skin with a soft cloth, towel or napkin, without effort. Subsequently, it is necessary to inform the doctor about this during the examination. PerThe “button” must be carefully monitored so that the assessment of the result of the Mantoux test is reliable.
And if there is severe redness?
If after the sample was taken, the injection site turned red, then do not panic. Three days later, the doctor will pay attention not to this sign, but to the seal - the papule.
Severe redness is not considered a positive reaction and is not an indicator of the presence of tuberculosis in a child.
The doctor can measure the site of redness and register the result if there is no “button” at the injection site.
We measure ourselves
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 negative Mantoux vaccine should look like. If, after the specified time after the injection, the resulting seal does not exceed 1 mm in diameter and redness is not observed, then the result is negative. It's okay, you can breathe a sigh of relief. A questionable result is given by a “button” that does not exceed 4 mm in size, 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, sores or pustules at the injection site, the formation of a seal larger than 17 mm.
It's better to know what a Mantoux vaccination 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 "button" of Mantoux is handled incorrectly. In this case, the child is sent for examination together with his parents to the TB dispensary. They will take all the necessary tests, and the phthisiatrician 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 normal cases is based on the annual dynamics. The size of the papule should decrease by a few millimeters per year, and by the age of seven years it should be almost invisible in a child.
What else matters?
Don't panic if your child is sent to a TB clinic. A positive reaction may indicate that the baby is a carrier of the stick, but at the same time it is not contagious. He can attend school, kindergarten. Such sticks are not transmitted through the blood. People around are infected only from a person with tuberculosis, by airborne droplets.
However, when the evaluation of the Mantoux test is positive, the child should be observed by a TB specialist. But if the specialist makes an appropriate diagnosis, then the little patient will have to undergo treatment.
First of all, he will be sent for a chest x-ray and sputum microbiology. In addition, all family members will also be required to be screened.
Phenol and allergies - what's the connection?
Children sometimes have allergic reactions to vaccinesMantu. The reason for this is individual intolerance to the components of the drug or hereditary predisposition. Often the culprit of allergies is phenol, which is part of the vaccine. This substance is toxic, but in small doses it does no harm. There are times when a child has intolerance to phenol, then allergic reactions occur. In any case, it is necessary to consult a specialist when the Mantoux test gave an allergic reaction of the body. Evaluation of the result after a while should not be accompanied by the following allergy symptoms:
- loss of appetite;
- skin rash;
- high temperature;
- weakness;
- anaphylaxis.
In this case, you can safely test the next time. But you need to remember that allergies can appear 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 was performed. Evaluation of the result, which entails even the slightest symptoms of an allergy in a child, forces parents to immediately consult a doctor. He will prescribe antihistamines to relieve the symptoms of the allergy. Often, side effects on Mantoux occur due to recent diseases, and may be accompanied by various ailments.
If a child has skin diseases, chronic infectious diseases, especially in the acute stage, an allergy to something, epilepsy or a cold, then Mantoux cannot be vaccinated. It is worth postponing this event and holding it after a month afterdisappearance of all symptoms. Any vaccinations weaken the immune system, so they should be given at different times. Otherwise, the evaluation of the Mantoux test result may be false positive.
Rejection of Mantoux
By law, parents can refuse Mantoux vaccination. She is voluntary. You can refuse by writing a statement at the clinic. This should be done with 100% certainty that the child has never had contact with a patient with tuberculosis. The Mantoux test weakens the child's immunity, like any other vaccination. To avoid this, you can use an alternative method and donate blood from a finger. The only disadvantage 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 above illustrate well what the reaction to Mantoux should be in children. In adults, it is practically no different.
Mantoux is an immunological test that indicates the presence of a tubercle bacillus in the body.
After the injection of a drug containing tuberculin, a reaction occurs. With its help, you can find out if a person is sick. At the injection site, inflammation appears, caused by blood cells responsible for immunity. Lymphocytes are attracted from the nearby blood vessels of the skin with the help of fragments of microbacteria. But not all lymphocytes are attracted, but only those that were already familiar with the Koch stick before.
If a person is infectedbacteria, then the inflammation will be large, the result will be positive, and if the possibility of infection was earlier, but it did not happen, then the reaction will be with pronounced, but not intense irritation. Of course, from a positive reaction it follows that the plaque was not due to the injection itself and possible skin irritation due to it, but because a certain reaction occurred.
Operation 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 placed. The assessment of the result (what the “button” should look like) will be reliable only when all the rules for caring for the injection site are followed.
Usually it has a convex swelling that rises above the general level of the skin, often reddened and dense to the touch. The more immune cells in the human body that have encountered the tuberculosis bacillus, the more pronounced and larger the seal will be.
Reaction to Mantoux 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 the complete absence of a “button”, or if it has a size of up to 1 mm. This result is considered normal. With a plaque size of two to four millimeters, its redness, the result is doubtful and can be considered a false positive. If the plaque is larger than 5 mm, the reaction is positive. If the diameter of the seal at the injection site in adults is more than 21 mm, the reaction is hyperergic.
So, Mantoux vaccination should be carried out every year in order to identify negative dynamics or possible infection. For example, for three years in a row, plaque sizes were recorded within 14 mm, and for the fourth year it increased to 20 mm. It is highly likely that infection has occurred. It is the turn of the Mantoux tuberculin test that prompts the phthisiatrician to prescribe additional examinations to a potential patient.
If the Mantoux test is alarming
Evaluation of the result (the photo has already been presented above), which raises doubts, should take place objectively. After all, there is still the possibility of an allergic reaction to the Mantoux test, and recent infections or already existing intolerance to any substances may also affect. In these cases, the reaction may show a positive result, so any factor that adversely 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 they pay attention to
After 72 hours, you need to see a doctor, where the Mantoux test will be examined. Evaluation of the result, the photo of which is located below, suggests that there are no problems. But the entire examination begins with the injection site. In this case, three states can be set:
- hyperemia;
- infiltration;
- no response.
It is very important to distinguish hyperemia from infiltration. To do this, they probe the “button”, and then a he althy area of \u200b\u200bthe skin in order todetermine the seal thickness. If the reaction is an infiltrate, then the density of the skin in a he althy area and at the injection site will be different. With hyperemia, the density of the skin is the same.
Next, you need to measure the plaque with a transparent millimeter ruler. Measure the transverse, relative to the axis of the hand, the size of the infiltrate and register it. It is strictly forbidden to perform these manipulations in a poorly lit room using improvised tools that replace the ruler. Only the seal size is to be measured. If only redness occurs at the injection site, and there is no papule, then it is recorded, but is not a reason to believe that a person has a positive reaction.
This is what a negative Mantoux test looks like.
What are patients saying?
Recently, there has been an increase in the number of people opposed to having their children undergo a Mantoux test. Evaluation of the result, reviews of parents about the procedure itself are quite categorical. In most cases, the negative attitude of adults against Mantoux lies in the fact that after it the children are sent to phthisiatricians. 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 bodyhuman.
