Emergency in Primorye: children fell ill after the Mantoux test due to an overdose

If a child gets sick after Mantoux, then this means only one thing - the respiratory infection virus was already in his body before the introduction of tuberculin. A weakened immune system causes a rapid onset of cough, runny nose and an increase in overall body temperature. Treatment of the child in this case should be fully agreed with the pediatrician, but the disease, as a rule, does not have any effect on the results of the test.

The simplest preventive measures prevent the development of colds and ARVI immediately after performing the Mantoux test.

Symptoms and first signs of tuberculosis in children

First of all, tuberculosis in children is manifested by such clinical signs as:

• weakness;
• stopping weight gain;
• irritability;
• fatigue during school hours;
• absent-mindedness;
• lagging behind peers in studies;
• body temperature – up to 37.5°C;
• enlarged lymph nodes;
• sweating;
• chills.Source: N.M. Koretskaya Tuberculosis in children and adolescents in modern conditions // Siberian Medical Review, 2010

Forms of tuberculosis and early signs

Clinical manifestations by age of children

Manifestations of the chronic form:

• sleep disorders;
• liver enlargement;
• lagging behind peers in physiological development;
• dry and pale skin;
• mild euphoria.

Why is the Mantoux reaction done?

Many parents mistakenly call Mantoux a vaccine. In fact, the injection is a way to diagnose tuberculosis in young children. This is due to the impossibility of performing fluorography, which produces dangerous x-ray radiation on the developing organism. Using a syringe, the doctor introduces a special composition containing weakened pathogens.

The purpose of the Mantoux test is to obtain a response. When tuberculin is administered, the baby's body encounters the tuberculosis bacillus. If he has not previously been in contact with the virus, then the immune system has practically no resistance and does not react with redness. If signs of infection or dead mycobacteria are present in the blood, a red spot, swelling or papule appears at the injection site. By its size, the doctor can judge the risk of infection of the child.

In recent years, the number of people suffering from various forms of tuberculosis has increased sharply. Therefore, doctors do not recommend abandoning the Mantoux test. But adults should know the basic principles of diagnosis and possible consequences so as not to panic.

Causes

Koch's bacillus has a shell that is resistant to acidic environments. It is able to survive freezing, drying, exposure to alkalis, and much more. etc. Characterized by the ability to form so-called L-forms with increased adaptability. The most pathogenic microbacteria for humans are:

• Mycobacterium tuberculosis humans;
• Mycobacterium bovis.

Microbacteria enter the body through contact, air, mixed and other routes. This is how the first inflammatory focus is formed. A child can also be infected during the mother's pregnancy - through the placenta or during childbirth, if it swallows amniotic fluid. Source: https://www.ncbi.nlm.nih.gov/pubmed/24548085 Marais BJ Tuberculosis in children J Paediatr Child Health . 2014 Oct;50(10):759-67. doi: 10.1111/jpc.12503. Epub 2014 Feb 19

Children at risk include:

• not vaccinated with BCG;
• long-term treatment with antibiotics, hormonal or cytostatic agents;
• having HIV status;
• living in unfavorable conditions (social and/or sanitary);
• having diabetes mellitus;
• with weakened immunity;
• under 2 years of age;
• and etc.

Why do children get sick after Mantoux?

The Mantoux test is not a vaccination containing live bacteria. Therefore, the risk of getting tuberculosis after injection is minimal. But sometimes there is a sharp increase in temperature and other symptoms characteristic of inflammation or ARVI. In most cases, the reason lies in improper preparation. Ideally, each baby should be carefully examined by a pediatrician, given a referral for general tests, and made sure there are no signs of influenza or other infectious diseases. Only after this is permission given to carry out the reaction.

In fact, due to lack of time, doctors miss important symptoms, which is fraught with complications. Among the possible reasons why the child fell ill after Mantoux are the following:

• The baby’s immunity is weakened by a recent acute respiratory infection, influenza or more serious inflammation occurred in a latent form.
• The baby has autoimmune diseases that were not previously diagnosed. Some children naturally have a lower level of lymphocytes, which are responsible for the formation of natural defenses, and there is a pathology of the thymus gland.
• Nutrition does not correspond to age in terms of the amount of vitamins and microelements; there is a lack of body weight, vitamin deficiency, and anemia.
• A few days before visiting the vaccination office, teeth began to emerge, and there were wounds or open erosions on the gums.

Can a child get sick after receiving a Mantoux vaccination? One of the reasons that doctors do not talk about is violation of the rules for storing and transporting the vaccine. Normally, it should constantly be at a certain temperature. Otherwise, a chemical reaction begins and the drug deteriorates. As a result, allergies and complications develop in the child’s body.

Can a child get sick after receiving a Mantoux vaccination? One of the reasons that doctors do not talk about is violation of the rules for storing and transporting the vaccine.

Types and forms of pathology

According to the period of occurrence in medicine, stages are distinguished:

• infiltration;
• decay;
• contamination;
• resorption;
• seals;
• the appearance of scars;
• calcification.

Doctor Komarovsky's opinion

An ardent supporter of flu vaccination and Mantoux tests is Dr. Evgeniy Komarovsky. And there is logic in his zeal, because thanks to vaccination and inoculation, the increase in morbidity and mortality has decreased by 80%, and life expectancy has increased.

Komarovsky clearly believes that the Mantoux reaction is worth doing. According to him, this makes it possible to diagnose whether a child has tuberculosis or not. In case of a positive response to the administration of tuberculin, hyperemia will occur against the background of allergies and an increase in temperature. The body will show a defensive response. And, conversely, in the absence of contact with viruses, it will “keep silent”, and the effect of the vaccination will not appear outwardly.

How does the disease progress?

The mechanism of development of such an infection includes several stages:

• entry of the pathogen into the upper respiratory tract (on the mucous membranes), from where, with a weak immune response, they enter the lungs;
• penetration into the alveoli of the lungs and further through their walls (without specific changes);
• entry into the lymph nodes and lymphatic pathways with further reproduction (here the infection can take a latent form and persist without external phenomena);
• circulation of microbacteria through the bloodstream without reproduction (about 2 weeks);
• spread of infection through tissues and organs, manifestation of a primary disease or latent infection;
• formation of immunity - formation of granulomas around microbacteria;
• infection (if the process does not progress, the granuloma becomes covered with connective tissue or resolves, the microbacterium inside it turns into the L-form);
• disease – transition of L-forms into rods.

How to prevent complications?

The Mantoux test is well accepted by the body and rarely produces side effects or complications. But what should parents do to prevent such health problems after vaccination?

• Be sure to do basic blood and urine tests and determine your hemoglobin level.
• Show the child to the pediatrician, monitor the examination and enter data into the card.
• For 4–5 days before the injection, avoid visiting crowds of people and shops. If possible, do not take your child to playgrounds.
• After consulting with your doctor, you can give an antihistamine.

A little prevention will several times reduce the risk of your baby becoming infected with ARVI or influenza and will help you recover faster after the test.

So, we figured out what to do if a child gets sick after Mantoux. Adults should carefully monitor the body's reaction, support the body with vitamins and proper nutrition. What symptoms or complications did your baby experience after tuberculin administration? Subscribe to our blog and share your own experiences with readers in the comments below.

And be healthy!

Treatment

Chemotherapy, antibiotics

Bactericidal and bacteriostatic drugs are used to achieve complete recovery. In this case, the correct combination of drugs is important, taking into account the resistance of some bacteria to this type of therapy. First, treatment is aimed at suppressing the growth of bacteria and eliminating their resistance to medications. Residual infection in the cells is then eliminated. Duration of therapy is 6-12 months.

Surgery

Pulmonary resection is practiced as a radical technique. The operation is performed for bronchial stenosis, fibrous-cavernous lesions, pleural empyema, abscesses in the lungs, tuberculomas prone to progression, etc. In addition, decortication is used, that is, removal of fibrous layers, and cavernotomy - cleansing of the opened cavity.

DOTS

A treatment system consisting of several levels: bacterioscopic examination, chemotherapy, anti-tuberculosis treatment.

Sources:

1. N.M. Koretskaya. Tuberculosis in children and adolescents in modern conditions // Siberian Medical Review, 2010.
2. A.V. Mordyk, E.A. Tsygankova, L.V. Puzyreva, A.A. Turitsa. Tuberculosis in children of the Russian Federation at the present stage // Pediatric pharmacology, 2014, v. 11, no. 3, pp. 27-30.
3. https://www.ncbi.nlm.nih.gov/pubmed/24548085 Marais BJ. Tuberculosis in children // J Paediatr Child Health. 2014 Oct;50(10):759-67. doi: 10.1111/jpc.12503. Epub 2014 Feb 19.
4. V.N. Krivohizh. Modern methods of early detection of tuberculosis among children and adolescents // Health is the basis of human potential: problems and solutions, 2013, pp. 570-585.

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Illness or reaction to the test

In order to strengthen the stability of the immune system, a person is given an injection.

Cells become acquainted with a new antigen, a substance that under normal conditions is perceived as foreign to the body and is not found in its internal environment under normal conditions. When an antigen enters the human body, antibodies begin to be produced by body cells that are released when the antigen appears.

Then an interesting complex AGATE (ANTIGEN + ANTIBODY) is formed and eliminated, that is, released into the environment. Thus, the process of differentiation of cells into friendly and foreign occurs and protection from a hostile environment is provided.

After becoming familiar with the antigen, memory cells form stable immunity. And these days the Mantoux reaction occurs, symptoms similar to those of the disease appear. But don't panic. This is a normal defense mechanism that worked in time. Everything will be fine with the child, his body functions normally and takes care of him.

Prices

Is it possible to do?

For runny nose and cough

It's better not to take risks

Many children, unfortunately, are susceptible to frequent colds, but this does not eliminate the need for tuberculin tests. If a child is sick, parents fear that the administration of tuberculin will further worsen their child’s condition.

First, you should make sure that your runny nose and cough are actually caused by a cold and not an allergic reaction. The symptoms of the two can be very similar. If an allergic reaction in the form of rhinitis is regular, this is not a reason to refuse the Mantoux test.

If the problem is still a cold, then rhinitis and cough, dry or wet, will not become stronger under the influence of the drug for mantoux. In some cases, general weakness may appear that is not associated with a cold. But a weakened body can give a false positive reaction to a tuberculosis test, so it is better to wait for complete recovery , and only a couple of weeks after that return to the question of performing Mantoux.

For ARVI

During viral infections, the body's defenses are undermined, and the immune system is aimed at fighting the causative agent of the disease. Therefore, if at this moment the child was given a manta, the reaction can also be positive or questionable.

In many cases, viral infections are a strong stress for the body and are sometimes expressed by unexpected symptoms. it is better to wait with any intervention during this period until the immune defense is completely restored.

At a temperature

A rise in temperature is evidence of a malfunction in the body. Perhaps this is a signal that the child is beginning to develop an infection or inflammatory process. It is worth observing his condition for several days before deciding whether mantu can be done, and then consult with a pediatrician.

If this is a short-term temperature jump associated, for example, with the vigorous activity of a child who has just been energetically running and jumping, this is not a reason to cancel the test . In any case, before administering tuberculin, it is necessary to monitor the condition of the throat and general health.

For other diseases

You can wait out the infection, but what to do if there is a chronic pathology in the body? Is it possible to administer manta to a patient who has been suffering from dysfunction of internal organs and systems for a long time? There are clear contraindications to the test when:

• epilepsy;
• rheumatism;
• bronchial asthma;
• severe allergies;
• rashes and other skin disorders at the injection site.

Tuberculin has no effect on the course of these diseases, but the test results cannot be considered reliable. For any other serious chronic disease in the acute stage, it is recommended to refrain from taking the mantoux test until the period of remission. Another important contraindication is vaccination. If a month has not passed after any of the vaccinations, you should wait a while with mantu .

How might this affect the results?

Any disruption in the functioning of the body when you are sick, be it a weakening of the immune system, a hormonal surge or an inflammatory process, can change the clinical picture of the blood, and with it the body’s ability to produce antibodies and respond to various irritants. Testing for tuberculosis in such cases may give unexpected results.

But even if the reaction suddenly turns out to be questionable or positive, parents should not panic. This means, first of all, the need for additional examinations and systematic medical supervision.