Mantoux test in children - detection of TB
Mantoux test in children is conducted annually.For the first time in the form of a tuberculin reaction Pirke was used in the early 20th century.Mantoux (r.Mantu - after the French doctor who proposed it) is a modification reaction Pirke.In Russia, this kind of tuberculin held since 1965.
What is the Mantoux test
incidence of tuberculosis is high enough in the world, including in our country.However, children's tuberculosis Tuberculosis - a full recovery is not guaranteed in Russia are rare thanks to the timely detection and treatment of this disease.Detection of tuberculosis in children TB in children - Actual problems of modern due to the fact that, penetrating into the organism Mycobacterium tuberculosis cause sensitization (allergy) body.Allergies to identify Mycobacterium tuberculosis using Mantoux test, which is carried out by intradermal tuberculin - drawing (lysate) from Mycobacterium tuberculosis, heat-killed.
sensitization by Mycobacterium tuberculosis is also being developed in response to vaccination against tuberculosis - BCG.
Reaction to Mantoux, a child may be different depending on the time that has elapsed since the BCG, and possible infection.On the third day after setting the Mantoux test at the injection site may occur a slight thickening of the skin - a papule.It is measured and evaluated.In order not to confuse the papule with reddening of the skin, it pressed against a transparent ruler - papule becomes white and has a clear edge.Measure the transverse dimension of the papules without taking into account its surrounding redness.Redness is recorded only if there is no papules.
rank Mantoux test in children
When checking the Mantoux test is evaluated according to a strictly defined criteria:
- negative r.Mantu -complete lack of infiltration (papule) at the injection site or a trace of infiltration injections with no more than 1 mm;
- questionable r.Mantu - infiltrate the size of 2-4 mm, or only redness any size without infiltration;
- positive r.Mantu - infiltrate a diameter of 5 mm or more infiltration or growth with respect to the last year more than 5 mm (increasing r.Mantu);weakly positive r.Mantu - infiltration of 5-9 mm, medium intensity - 10-14 mm, expressed - 15-16 mm;
- hyperergic (expressed excessively) r.Mantu - infiltration of 17 mm or more, or vesicles, necrotic (with the formation of vesicles and necrosis) reaction, regardless of the size of infiltration, lymphangitis and lymphadenitis Lymphadenitis - when inflamed lymph nodes (inflammationadjacent lymph vessels and lymph nodes), child screenings (the emergence of several hotbeds around the main, parent).
Normal Mantoux children
r.Mantu What is considered normal in children?Normal reaction may be different, depending on the time elapsed from the date of vaccination against tuberculosis (BCG), which is conducted for all children in the hospital, as well as the size of the hem, the remainder of the vaccination:
- 1 year of life, or one year after BCG- the norm is the quantity of infiltration after r.Mantu 5-15 mm (if after BCG scar was equal to 6-10 mm) or 11.5 mm (BCG scar from 2-5 mm);
- 2 years of life - Mantoux rate in children, if the size of the infiltrate remained unchanged or slightly decreased compared to last year;the value of BCG scar does not matter;
- 3-5 years of life - the amount of infiltration is reduced and does not exceed 5-8 mm;
- 6-7 years of life - fading reaction to the doubtful or negative.
bad Mantoux test the child
«bad» r.Mantu - is a relative term.Since almost all TB-infected adult population of the planet, has a value of the time of introduction into the organism Mycobacterium tuberculosis, ie tubinfitsirovanie.Moment tubinfitsirovaniya accompanied superelevation r.Mantu, that is, its growth compared to the previous figures.It says that under unfavorable conditions (fatigue, malnutrition, frequent stress and so on), a child may develop TB.
considered a sign of turn:
- appearance of the first positive r.Mantu (infiltration of 5 mm or more), though it was negative or doubtful;
- previous amplification reaction 5 mm or more;
- hyperergic reaction (infiltration of more than 17 mm) irrespective of the limitations of vaccination;
- r.Mantu kept at more than 12 mm after 3-4 years after BCG vaccination.
case of suspected infection should first eliminate all factors that could affect the r.Mantu.It is an allergy to the components of the tuberculin, or to any other substances, which contacted the child, recent illnesses, the introduction of a vaccine a month ago and so on.
child who was identified turn fully examined in order to eliminate the disease of tuberculosis, being treated with anti-TB drugs and watch for a year.
Mantoux test in children is very important.Due to its systematic, it is possible to prevent and promptly identify cases of childhood tuberculosis.