The
Mantoux test (also known as the Mantoux screening test, tuberculin sensitivity
test, Pirquet test, or PPD test for purified protein derivative) is a
diagnostic tool for tuberculosis. It is one of the major tuberculin skin tests
used around the world, largely replacing multiple-puncture tests such as the
Tine test. The Heaf test was used until 2005 in the UK, when it was replaced by
the Mantoux test. It is endorsed by the American Thoracic Society and Centers
for Disease Control and Prevention.
Classification of Tuberculin Reaction
The results of this test must be interpreted carefully. The
person's medical risk factors determine at which increment (5 mm, 10 mm, or 15
mm) of induration the result is considered positive. A positive result
indicates TB exposure.
5 mm or more is positive in
- An HIV-positive person
- 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
10 mm or more is positive in
- Recent arrivals (less than five years) from high-prevalence countries
- Injection drug users
- Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
- Mycobacteriology lab personnel
- 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
15 mm or more is positive in
- Persons with no known risk factors for TB
SUMMARY
Ø This is used to determine if a person has been infected
or has been exposed to the TB bacillus.
Ø This utilizes the PPD
(Purified Protein Derivatives).
Ø The PPD is injected intradermally usually in the inner aspect of the lower forearm
about 4 inches below the elbow.
Ø The test is read 48
to 72 hours after injection.
Ø (+)
Mantoux Test is induration of 10 mm or more.
Ø But for HIV positive clients, induration of about 5 mm is considered positive
Ø Signifies exposure
to Mycobacterium Tubercle bacilli
