MANTOUX SCREENING TEST (Tb skin test )

PBL 12Directed ByDr. Niveen El-Wakeel

Side Effects of Mantoux Test

Mechanism of Mantoux testResults of Mantoux test

what is Mantoux test ?

procedure of Mantoux test

how to read the test ?

What is mantoux test?

Pirquet test

PPD test

Tuberculin sensitivity test

• Tuberculin

• Tuberculin is a glycerol extract of the tubercle bacillus.

• It is a precipitate of species-nonspecific molecules obtained from filtrates of sterilized, concentrated cultures. 

• History• The tuberculin reaction was

first described by Robert Koch in 1890.

• The test was first developed and described by the German physician Felix Mendel in 1908.

• It is named after Charles Mantoux, a French physician who built on the work of Koch and Clemens von Pirquet to create his test in 1907. 

An intradermal test due to hypersensitivity to PPD that indicates past or present infection with tubercle bacilli.

Tuberculosis 3

Procedure:

Inject 0.1 ml of 5 tuberculin units I.D, usually on the forearm.

The patient's arm is examined 48-72 hours after the tuberculin is injected. 

The reaction is an induration (swelling) around the site of the injection.

The diameter of the indurated area

is measured

Diameter of the induration is 10 mm or greater

Positive test

10 mm

Diameter of the induration is 10

mm or less

Negative test

5 mm

It is impossible to distinguish between active disease & past infection by a positive tuberculin test.

prior exposure or infection with other mycobacteria or vaccination with BCG

False +ve test

impaired CMI response

False -ve test

Why It Is Done

People in close contact with someone known to have TB.

Health care workers who are likely to be exposed to TB.

People with TB symptoms, such as an ongoing cough, night sweats, and unexplained weight loss.

People who have had an abnormal chest X-ray.

People who have had a recent organ transplant or have an impaired immune system, such as those with human immunodeficiency virus (HIV).

A tuberculin skin test should not be done for people:

With a known TB infection.

Who have had a previous severe reaction to the TB antigens.

Who have a skin rash that would make it hard to read the skin test

Side effects:Tachycardia

Chest tightening, breathing difficulty

Fever

Dizziness

Unusual tiredness or weakness

Skin rash

Quiz 1) What is the result if the it is 10 or

more mm induration ?

A. People with no risk factor of TbB. With HIV infectionC. Children younger than 4 years oldD. Have close contact of people with

infectious Tb

2) What is meant by false positive reaction ?

A. May not react to the test even though they are infected with M. tuberculosis

B. May not react to the test even though they are not infected with M. tuberculosis

C. May react to the test even though they are not infected with M. tuberculosis

D. May react to the test even though they are infected with M. tuberculosis

Quiz

3) What is meant by false negative reaction ?

A. May react to the test even though they are infected with M. tuberculosis

B. May not react to the test even though they are not infected with M. tuberculosis

C. May react to the test even though they are not infected with M. tuberculosis

D. May not react to the test even though they are infected with M. tuberculosis

Quiz

Hager DorghamCheima MedjahedDoaa SabriJalila AhmedFatin Aqilah NorazakNasuha Bukhari Ahmed KataryKarim RashadKhairul HazwanHazwan AkmalTaher RizkMohamed MosaadYousuf Hamed