Mendel mantoux-test

An overview and description of the PPD test used to diagnose tuberculosis

1. MENDEL-MANTOUX TEST

2. INDEX Introduction Procedure Results

3. Introduction A lso known as the tuberculin sensitivity test. S creening tool for tuberculosis (TB) Uses a Purified protein derivative (PPD) tuberculin, a precipitate of glycerol molecules obtained from filtrates of sterilized and concentrated cultures of TB.

4. Procedure A standard dose consists of an intradermal injection of 0.1 ml solution for injection in the inner surface of the forearm Test is read 48 to 72 hours later. A person who has been exposed to the bacteria is expected to mount an immune response.

5. The reaction is read by measuring the diameter of induration (palpable raised, hardened area) across the forearm in millimeters. Erythema should not be measured

6. Results Classification of reaction

7. Induration of 5 mm – 9 mm Persons with recent contacts with a TB patient Persons with nodular or fibrotic changes on chest X-ray consistent with old healed TB Patients with organ transplants, and other immunosuppressed patients

8. 10 mm – 14 mm Injection drug users Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.) Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc.) Children less than four years of age, or children and adolescents exposed to adults in high-risk categories.

9. 15 mm or more Persons with no known risk factors for TB

10. False positive result Those who have received a BCG vaccine. Interpreted as latent TB infection. May be caused by a non- tuberculous mycobacteria. Another source of false positive results can be allergic reaction or hypersensitivity.

11. False negative result Infectious mononucleosis Anergy Live virus vaccine - The test should not be carried out within 3 weeks of live virus vaccination. Sarcoidosis Hodgkin's disease Corticosteroid therapy/ Steroid use Malnutrition Immunologically compromised

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