The Mantoux test is the main means of determining predisposition to tuberculosis in preschool and primary school age. Fluorographic examination is already available for high school students. The main condition for obtaining the correct result is to perform the procedure on healthy children.
Therefore, it is worth considering what can affect the diagnostic result? Is it possible to make mantu after an illness? In what situations is this procedure contraindicated?
How is tuberculosis diagnosed in children?
The method of making manta for a child was created in order to test the young body in the most gentle way. This will allow tuberculosis to be identified at an early stage and treatment to begin before the disease leads to severe complications. This simple procedure involves introducing the pathogen under the skin of the arm from the inside of the forearm.
After three days, the doctor checks the injection site using several parameters:
- color;
- density;
- size.
A negative reaction to manta is determined by healthy skin color and the presence of only a trace of the injection on the surface of the skin. If there is slight redness and swelling from mantoux, the doctor may recommend repeating the procedure due to the dubiousness of the result.
A positive reaction in children is determined by the size of the injection site from 4 mm and the noticeable density of the papule. In the event of the formation of suppuration, a wound and swelling of more than 17 mm, the baby is urgently sent for additional examination and treatment with suspicion of an active form of tuberculosis.
How to get a medical outlet for Mantoux from an allergist
A medical guide from Mantoux from an allergist can only be obtained personally from a doctor and after a full examination of the child. An allergist will issue a ban on such tuberculin diagnostics if the patient:
- there is a history of allergies to medications;
- Previously, during the test, an inadequate reaction of the body was noted;
- there is a high risk of developing allergies - for example, a child has such a reaction to food, animal hair, plant pollen.
To visit an allergist, you should stock up on some documents from your pediatrician:
- medical record with a specialist’s opinion on the patient’s general health condition;
- a document reporting the timing and results of vaccination(s).
If necessary, the allergist can refer the patient to an immunologist for additional examination.
What could cause the results to be distorted?
There are a number of factors due to which the mantoux reaction may be distorted. An incorrect diagnosis will prolong the examination time. Thus, you should not diagnose for tuberculosis if you have been vaccinated against another disease a short time before.
The presence of allergies or infectious diseases can also lead to a false diagnosis. A similar effect will occur even with a slight cough or runny nose. In addition to bacterial or viral infections, the diagnostic result in adults can be affected by rheumatism or a woman’s menstrual period.
You should notify your doctor about all such problems in advance.
The cause of a false reaction may be the quality of the drug. If the expiration date has expired or the storage conditions of the tuberculin test have been violated, it is strictly prohibited to administer manta using it. Compliance with technology during the procedure and evaluation of the results will be the key to the correct result. Therefore, only an experienced specialist can test.
Mantoux for a runny nose
Doctors advise refraining from vaccination at the first sign of a cold. Nasal discharge is a symptom of acute respiratory infections or acute respiratory viral infections that should not be neglected. These diseases are a direct contraindication to the administration of tuberculin.
During the period of colds, viral and infectious diseases, human immunity is weakened.
The Mantoux reaction involves the introduction of pathogenic substances into the body, which require strength to fight, and which the body has already spent to fight the disease. In this case, the procedure is postponed for about a month.
Features of caring for the injection site
The reaction to tuberculin is checked some time after administration of the drug. Therefore, it is worth following some rules for caring for the injection site. So, it should not be covered with any means, be it body cream, iodine or other external application. Although, contrary to popular belief, water does not have any effect on the test result, it is best to avoid contact with it and other liquids.
Squeezing, friction or exposure to sweat can distort the result of mantoux. Therefore, until the reaction is checked, you should not wear tight, constricting clothes.
Or cover the injection site with a plaster or other means. Although the graft may be itchy, you should not scratch it. Such manipulations will only intensify the allergic reaction. Applying these simple rules along with other precautions will protect against the consequences of a false mantoux reaction.
When the mantoux test is contraindicated
There are a number of conditions under which manta rays need to be transferred or replaced with another diagnostic method:
- various types of dermatitis;
- exacerbation of chronic infection;
- presence and activity of somatic diseases;
- mental disorders including epilepsy;
- vaccinations given in the last month before the intended introduction of tuberculin;
- respiratory diseases or weakened immunity for other reasons.
You must notify your doctor about all these contraindications in order to issue a medical exemption. Depending on the situation, he will appoint another day when you can place the manta. Or he will choose another way to test the body for a predisposition to tuberculosis.
What happens if you give Mantoux to a sick child?
If you give Mantoux to a sick child, the following may happen:
- the course of the disease will worsen, the child’s condition will deteriorate significantly;
- some pathologies can transform into a chronic form;
- the test result will be unreliable.
All this is associated with a sharp decrease in immunity after intradermal injection of tuberculin - in fact, this is a natural process, but for a known sick child it will be dangerous in terms of health.
And receiving a false positive result is a reason to order a full examination of the patient to exclude the presence of Koch bacilli in the body.
Mantoux after illness
Since it is not worth putting manta immediately after an illness, it is important to know how much time you need to wait before the procedure. This factor depends on the characteristics of the disease.
It is recommended to give mantu to children after ARVI 2 weeks after complete recovery. With chickenpox, the recovery period for a young body is extended to a month. After discharge, a medical exemption must be issued for 3 months. And if after this time period the test result is doubtful, additional examination by a TB specialist will be required. After measles, it will take at least 45 days to restore immunity.
It is necessary to be especially careful regarding vaccinations and other diagnostic procedures if the child’s body is affected by a viral disease called mononucleosis. A feature of this disease is damage to the cells on which immunity depends. Therefore, during the entire recovery period, the child will be susceptible to colds and other infections. And any contact with tuberculin can cause infection.
Is it possible a week after chickenpox, measles?
After chickenpox and measles, vaccination a week later is strictly prohibited. If a child has had measles, then the exemption is set for at least 1.5 months. Experienced specialists increase this period to 3 months.
As for chickenpox, even after all the symptoms (and their consequences) have disappeared, if the child has fully recovered, tuberculin can be administered for diagnosis only after 6 months. Otherwise, the result may be false positive, and this entails repeated diagnosis.
After skin diseases
Most dermatological diseases are a strict contraindication to tuberculin vaccination. This prohibition applies even if the symptoms are not located at the site of the subcutaneous injection.
If the skin disease is not chronic, but occurs in an acute form, then first the child undergoes a full course of therapy, then undergoes 1 month of rehabilitation, and only after a repeated thorough examination can the pediatrician give the go-ahead for the Mantoux test.
How soon should a child be given injections after mononucleosis?
Mononucleosis is an infectious disease that affects the lymph nodes. As the pathology progresses, the child’s immunity weakens by at least 40%, and this level of the protective system will remain for 3-6 months even after undergoing therapy.
Tuberculin vaccination is carried out only six months after recovery; many doctors play it safe and give a waiver from Mantoux for 12 months.
If the rules are violated, the adenoids may grow, the patient will experience shortness of breath, the ability to breathe through the nose will disappear, and a hoarse voice will appear. These problems can only be corrected through surgery.
Consequences of introducing tuberculin into a weakened body
When determining how long after an illness one can make mantu, a wise doctor will think about the consequences of haste in this matter.
Tuberculin introduced into a weakened body can lead to the following consequences:
- acute signs of a cold in the form of cough and runny nose;
- attacks of nausea and vomiting;
- signs of cephalalgia;
- dizziness;
- increased body temperature, manifested in the form of chills or fever;
- skin rashes;
- with complications of an allergic reaction, angioedema or anaphylactic shock are possible;
- diarrhea or stool retention.
Early diagnosis of tuberculosis is very important. But you shouldn’t risk your health by trying to speed up the diagnostic process.
Who makes the decision to postpone the procedure?
The decision about when to make mantu after a child’s illness is made by the parents. Medical facility workers cannot begin performing the procedure without their consent. You can agree to or refuse a procedure only after consultation with your doctor.
Let's summarize: the mantoux test is one of the main methods for diagnosing predisposition to tuberculosis. However, it should not be done in the presence of respiratory and a number of other diseases that weaken the immune system, or immediately after recovery.
Violation of this requirement leads to a number of undesirable consequences. The type of illness will determine how many days later it is possible to carry out diagnostics in a safe mode. And does it make sense to replace the subcutaneous injection of a tuberculin test with another method.
How to replace a sample with complete medical drainage
Even if the doctor has given the child a complete medical diversion from Mantoux, it is necessary to diagnose tuberculosis.
For this, doctors offer different methods - Diaskintest, PCR, blood test for ROE. The first option is considered the most informative, accessible and safe - the administered drug reacts not to the immunity of the child’s body, but to a specific protein secreted by the causative agents of the disease. Evaluation of the results of such diagnostics proceeds identically to Mantoux - 72 hours after the procedure, a medical professional measures the papule. Only a result in which the diameter of the “button” does not exceed 2 mm will be negative.
Doctors warn that instead of Mantoux, in order to obtain reliable results, it is better to carry out several examinations at once - for example, combine Diaskintest and a blood test for ROE.
Medical withdrawal from Mantoux can be temporary and complete, but it is given only by a doctor after examining/examining the child. Even with a complete ban on tuberculin diagnostics, manipulations must be carried out - PCR, Diaskintest, and blood tests for ROE are possible. The maximum temporary medical withdrawal lasts 6 months, but it can be extended by a doctor if necessary.
