What is the size of Mantoux: the norm in children
Many readers are interested in what size Mantoux is the norm in children? To answer this question, we offer a comprehensive study.
What you need to do Mantoux
Mantoux reaction is a minimally invasive and informative method for identifying the causative agent of tuberculosis – infection with Koch mycobacterium. With its help, early diagnosis is possible when there is no symptomatology. Tuberculosis is an infectious and inflammatory disease, most often affecting the respiratory system. Less common are foci of inflammation in the bones, eyes, kidneys, and other organs. For centuries, there was no cure for this disease, and the fate of the sick was a slow fading. In the 20th century, antibiotics, vaccines, and Pirke test appeared. It became known what the size of the Mantoux should be – the norm in children. However, even now the epidemiological situation for tuberculosis is extremely unfavorable. Therefore, the role of tuberculin diagnostics cannot be underestimated.
Principle of procedure
The Pirke test (Mantoux test) is a specific test for the detection of antibodies to tuberculosis. It shows whether the body has been in contact with mycobacteria and how much the pathological process is running. In medical practice, Mantoux is done at regular intervals throughout the child population up to 15 years. In adults, this diagnostic method is not massively used, since fluorography is done for the same purpose. The principle of the process is the intradermal administration of tuberculin – serum obtained from killed mycobacteria. The injection site is the inner surface of the middle third of the forearm.
The injection site should not be exposed to extraneous influences – scratching, wetting, overheating. Otherwise, false-positive reactions are possible.
It is especially difficult to keep track of the kids. But since the size of the Mantoux and the rate per year are very important, you need to try. The result is evaluated after 72 hours. At the injection site of tuberculin, redness forms with a tubercle in the center. A ruler measures its diameter and fixes it on a medical record.
Mantoux size: normal in children
Normally, people vaccinated with BCG vaccine should have immunity – the produced antibodies in response to vaccination. Therefore, the presence of hyperemia does not in all cases indicate infection. So, the size of the Mantoux (the norm per year) is 5-15 mm. The values above and below are considered very carefully to find out if there is hypersensitivity to tuberculin.
Assessment of results: Mantoux size – the norm in children
If puffiness and hyperemia are less than or equal to 5 mm in diameter – this is not bad. This size of Mantoux is the norm. It indicates the presence of immunity. The size of hyperemia is less than 1 mm or the complete absence of reaction is bad. This means that vaccination did not bring the expected result, and BCG administration must be repeated. An alarming indicator is the excess of hyperemia from 6 to 10 mm, as well as the appearance of ulcers. In this case, the consultation of a TB doctor is recommended. As we already mentioned, in the period after vaccination, immunity is built, and the strength of the reaction changes. So, the size of Mantoux (the norm per year and other periods for 1-1.5 years after vaccination) can be increased.
In two years, the size of the scar after BCG no longer matters. The reaction after vaccination should decline. The norm will be an immune response, which will remain at the same or lower level than in a year.
An increase in the diameter of puffiness (plus 4-6 mm) in comparison with Pirke at 1 year is an indication for an additional examination. It is also required in a number of other cases. For example, it happens that a large Mantoux size is the norm in children. This may be a false positive reaction or an allergy to tuberculin. In this case, one of the more highly sensitive samples is carried out.
Toddlers under 1 year old
If we take the result under the age of one year, then the norms of tuberculin diagnostics are as follows:
In the case when the scar after vaccination has a value of 6-10 mm, then the indicator is considered normal 5-15 mm, and not 5, as in the usual case.
16 mm is a dubious reaction, and over 17 is an infection.
If the scar has a size of 2-5 mm, then hyperemia in a diameter of 5-11 mm will be a normal reaction.
Puffiness in the amount of 12-15 mm is considered doubtful, and the size of more than 16 mm indicates an infection.