What should a normal Mantoux reaction look like?

Why doesn't the manta trail go through?

There can be a lot of factors why the trace of a manta ray does not go away for a long time. The most common of them is the individual characteristics of the body. For some people, the test will pass 4-5 days after the administration of the drug, at the same time, there is a category of people for whom the effect remains for the rest of their lives. If the child feels well, but the manta does not pass, it is too early to ring the bells.

In addition, the healing of the mark is greatly influenced by how long ago the child was vaccinated with BCG. After all, it is aimed at creating immunity against the bacillus, the extract from which is administered during the Mantoux test. If BCG was done very recently, the mark may acquire a bright red tint and may not go away for a long time.

Also, healing is directly affected by the saturation of the blood with protein enzymes. Children whose spots do not heal for too long may be referred to a specialist for further examination to accurately rule out the risk of disease. It is worth noting that if the child is allergic, then the possibility of an allergy to the administered drug cannot be ruled out. An allergy to an extract from a tuberculin bacillus gives a quick and false-positive result, in which case you need to consult a doctor and stop the effects with antihistamines, then the trace will go away.

The reasons for the long healing of Mantoux may be purely mechanical. For example, the mark cannot be rubbed, steamed or treated with brilliant green and hydrogen peroxide. Some doctors do not even recommend covering it with a band-aid. Under no circumstances should you squeeze the swollen area!

BabyMother

Task 2 of 14

How often do you take a tuberculosis test (eg Mantoux)?

• I don’t even remember when was the last time
• Every year, without fail
• Once every couple of years

Task 3 of 14

Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

• Yes, I wash my hands all the time
• No, I don't follow this at all
• I try, but sometimes I forget

Task 4 of 14

Do you take care of your immunity?

• Yes
• No
• Only when sick
• I find it difficult to answer

Task 5 of 14

Have any of your relatives or family members had tuberculosis?

• Yes, parents
• Yes, close relatives
• No
• I can not say for sure

Task 6 of 14

Do you live or work in an unfavorable environment (gas, smoke, chemical emissions from enterprises)?

• Yes, I live permanently
• No
• Yes, I work in such conditions
• Previously lived or worked

Task 7 of 14

How often are you in damp, dusty or moldy environments?

• Constantly
• I'm not there
• Previously was
• Rarely, but it happens

Task 8 of 14

Do you often get sick with acute respiratory infections or acute respiratory viral infections?

• I'm constantly sick
• Rarely, no more than once a year
• Often, more than 2 times a year
• I never get sick or once every five years

Task 9 of 14

What kind of life do you lead?

• Sedentary
• Active, constantly on the move
• Sedentary

Task 10 of 14

Does anyone in your family smoke?

• Yes
• No
• Happens sometimes
• Used to smoke

Task 11 of 14

Do you smoke?

• Yes, I smoke regularly
• No and never smoked
• Rarely, but it happens
• Previously smoked, but quit

Task 12 of 14

How old are you?

• Under 18
• From 18 to 25
• From 25 to 40
• More than 40

Task 13 of 14

What gender are you?

• Woman
• Man

Task 14 of 14

Do you often experience stress?

How many days does it take for the trail from Mantoux to pass? On average, doctors say that the trace from the Mantoux test disappears from 5 to 14 days. If after this time the situation does not improve, it is better to consult a doctor. In order for the mantoux stain to go away as quickly as possible, you need to follow the recommendations of doctors.

There can be a lot of factors why the trace of a manta ray does not go away for a long time. The most common of them is the individual characteristics of the body. For some people, the test will pass 4-5 days after the administration of the drug, at the same time, there is a category of people for whom the effect remains for the rest of their lives. If the child feels well, but the manta does not pass, it is too early to ring the bells.

In addition, the healing of the mark is greatly influenced by how long ago the child was vaccinated with BCG. After all, it is aimed at creating immunity against the bacillus, the extract from which is administered during the Mantoux test. If BCG was done very recently, the mark may acquire a bright red tint and may not go away for a long time.

Also, healing is directly affected by the saturation of the blood with protein enzymes. Children whose spots do not heal for too long may be referred to a specialist for further examination to accurately rule out the risk of disease. It is worth noting that if the child is allergic, then the possibility of an allergy to the administered drug cannot be ruled out. An allergy to an extract from a tuberculin bacillus gives a quick and false-positive result, in which case you need to consult a doctor and stop the effects with antihistamines, then the trace will go away.

The reasons for the long healing of Mantoux may be purely mechanical. For example, the mark cannot be rubbed, steamed or treated with brilliant green and hydrogen peroxide. Some doctors do not even recommend covering it with a band-aid. Under no circumstances should you squeeze the swollen area!

If the mark does not cause discomfort to the child, then a simple consultation with a pediatrician is sufficient, who, if necessary, will refer the child to a phthisiatrician for examination. Most likely, the doctor will advise you not to disturb the wound again and eat fewer allergens. However, there are symptoms for which you need to rush to the hospital, as their consequences can be unpredictable. These include pain, excessive enlargement and redness of the papule, as well as its suppuration. This happens for the following reasons:

If Koch bacilli are present in the body in active form. This is, in fact, a stage of tuberculosis. Since treatment is much more effective in the early stages, you should immediately consult a doctor who will take action.

Individual intolerance to the administered drug. This reaction develops when the injection was given without taking into account the child’s contraindications. Here you also need to go to the hospital.

Sepsis. One of the most unpleasant and life-threatening causes. If a child experiences a sharp deterioration in health, and the trace of Mantoux festers, you need to go to the hospital as soon as possible, because sepsis can develop at lightning speed - within 1-2 days. High temperature is not an accurate marker of such inflammation; it can often be normal or even low, but the heartbeat and breathing are impaired. If sepsis is suspected, the child is given a rapid blood test to determine the number of leukocytes. You need to know that sepsis occurs mainly due to incorrect injection.

In order for the mantoux mark to heal as quickly as possible, you must follow the recommendations of the doctor who administered the vaccination. It is necessary to limit the contact of the papules with water, since tap water can wash out the composition and the result will be false negative. In addition, the child needs to be protected from allergens such as citrus fruits and sweet water. When the papule measurements are taken, you can return to your normal diet.

After trying mantu, the child may experience a slight increase in temperature, some lethargy and drowsiness, and a slight loss of appetite. If the symptom is itching all over the skin, swelling of the nasopharynx or urticaria, then an allergy has occurred to the drug. To ensure that side effects do not occur, the mantu test should only be done on healthy children; it is prohibited from doing it for influenza, ARVI, sore throat and other active diseases. If, after trying mantu, a child feels very tired and refuses to eat, this is a reason to consult a doctor as soon as possible.

In general, if the papule does not cause concern to the child and does not interfere with his life in any way, there is no need to panic. Even heredity plays a big role in this; remember the mother and father of the child and their reaction to manta rays. To reassure yourself, you can consult a phthisiatrician who will either confirm your fears or dispel them.

The Mantoux test is one of the most frequently performed medical procedures for children. However, its implementation raises a lot of questions and concerns among parents. Many categorically refuse to do it, ignoring the importance of this manipulation and its role in the future fate of the child.

Most of the fears of young parents are based on the possible development of complications, the absence of which no one can guarantee, as well as ignorance of what symptoms should be considered normal.

Most often, questions arise about how long a Mantoux mark should last on a child’s skin and what it should look like during this period. Let's try to find out.

The first Mantoux test must be taken as soon as the child turns one year old; a similar procedure is repeated every year. The test results are carefully recorded in the child’s medical record and compared with previous ones. In particular, doctors pay attention to the size of the papule and the duration of the skin reaction.

The Mantoux reaction is a unique response of the body to the introduction of tuberculin, an extract from carrier bacteria, injected into the baby’s forearm. At the injection site, the attraction of T-lymphocytes that have “acquaintance” with Koch’s bacillus begins; they accumulate under the skin, so the growth of the button begins.

After administration of the drug, you need to carefully monitor changes in the papule. An increase of up to 2 mm is normal; swelling of 2 to 4 mm is also not cause for concern, but requires additional consultation.

The growth of a button from 5 to 16 mm is a positive reaction, and should alert parents and doctors; in this case, the child is registered with a phthisiatrician for more careful monitoring. A papule that appears, having a size of 17 mm and above, in most cases indicates a large number of tuberculosis bacteria in the body and possible infection.

It is worth remembering that all changes with a button take place in the first 3 days. The body's strongest response is observed on the third day, which is why the reaction is checked at this time.

Next, the skin reaction should gradually disappear, and normally after a week and a half there should be no traces of the drug administration on the child’s hand.

The duration of the reaction may vary depending on the individual characteristics of the child’s body: sometimes the trace of Mantoux can be completely unnoticeable already on the second or third day, or can persist for more than a week.

However, if nothing bothers the child and the papule itself is not inflamed, not seriously enlarged and noticeably decreases over a short time, then there is no need to worry.

A recent BCG vaccination, which is done to create immunity against tuberculosis pathogens, can also influence the duration of the reaction. The Mantoux test determines the presence of these bacteria in the body, which is expressed in a long-lasting and pronounced skin reaction.

The child himself can provoke a long-term reaction to the Mantoux test if he does not follow the rules of caution. In particular, it is strictly prohibited:

• rub the injection site with a washcloth;
• bathe in hot water, steam papules;
• squeeze out liquid from the papule;
• treat the wound with brilliant green, iodine, peroxide.

In addition to those described above, the reasons why Mantoux does not pass may also lie in the individual characteristics of the child’s body. In most children, the swelling on the arm reaches a size of up to 4 mm on the third day, but in some patients such a papule can persist throughout life.

Such a button should not cause great concern, since such a reaction is a consequence of:

• oversaturation of the body with proteins;
• influence of hereditary factors.

Children with such a reaction are registered with a phthisiatrician. They require increased attention, as they have a predisposition to tuberculosis and are at risk for this disease.

Also, speaking about a long-term Mantoux reaction, you need to remember that this may be a consequence of the development of an allergic reaction to the administration of the drug. In this case, you should have antihistamines on hand to help cope with unpleasant symptoms. In the future, you should consult an allergist.

If after 5 days the injection site festers, swells, and the child has a fever, then a visit to a TB doctor is required. This may indicate:

• presence of illness;
• drug intolerance;
• violation of the drug administration technique and the development of sepsis.

Also, the reaction to the test may persist for a longer time than is determined by the norm if the manipulation was performed without taking into account contraindications.

In particular, the administration of tuberculin is prohibited when:

• allergies of any nature (even if there were in the past);
• epilepsy;
• rheumatism;
• skin diseases;
• asthma;
• infectious and inflammatory processes (colds).

It is important to remember that a long-term positive result is not tuberculosis itself!

You must first exclude the influence of all the factors described above, and then undergo a lot of additional examinations. Only after this is it possible to make a correct diagnosis.

So, excluding a false positive result, the doctor may prescribe Diaskintest, which will help deal with the situation without harm to health. It is appointed to:

• diagnose a disease;
• identify allergic processes;
• determine the activity of the inflammatory process.

Unlike the Mantoux test, Diaskin contains proteins of synthetic origin, characteristic of Koch's bacillus, thanks to which the drug will give an accurate answer with almost one hundred percent accuracy - whether tuberculosis is present in the body or not.

Parents who have the correct and necessary knowledge about the Mantoux test can avoid unnecessary panic when a reaction persists on the child’s skin for a long time and calmly analyze the situation. If detected in time, the disease can be easily defeated in the initial stages, ensuring a healthy future for the baby.

Bondarenko Tatyana

Expert of the OPnevmonii.ru project

What to do?

If the mark does not cause discomfort to the child, then a simple consultation with a pediatrician is sufficient, who, if necessary, will refer the child to a phthisiatrician for examination. Most likely, the doctor will advise you not to disturb the wound again and eat fewer allergens. However, there are symptoms for which you need to rush to the hospital, as their consequences can be unpredictable. These include pain, excessive enlargement and redness of the papule, as well as its suppuration. This happens for the following reasons:

If Koch bacilli are present in the body in active form. This is, in fact, a stage of tuberculosis. Since treatment is much more effective in the early stages, you should immediately consult a doctor who will take action.

Individual intolerance to the administered drug. This reaction develops when the injection was given without taking into account the child’s contraindications. Here you also need to go to the hospital.

Sepsis. One of the most unpleasant and life-threatening causes. If a child experiences a sharp deterioration in health, and the trace of Mantoux festers, you need to go to the hospital as soon as possible, because sepsis can develop at lightning speed - within 1-2 days. High temperature is not an accurate marker of such inflammation; it can often be normal or even low, but the heartbeat and breathing are impaired. If sepsis is suspected, the child is given a rapid blood test to determine the number of leukocytes. You need to know that sepsis occurs mainly due to incorrect injection.

How Mantoux changes by day

After Mantoux, children may experience a variety of symptoms on the first day, or there may be no signs of a reaction at all. Sometimes atypical phenomena are observed only on days 2-3. It all depends on how strong the reaction is, how it manifests itself and how the baby feels. In some cases, it is necessary to show the result to the doctor before the deadline of 72 hours.

Mantoux on the first day

On the first day after Mantoux, the baby is whiny, capricious, refuses to eat, sleeps a lot, or, on the contrary, worries. This is more likely a consequence of nervous stress after a visit to the hospital, rather than a reaction to the drug. But parents must still remain extremely vigilant. If the baby's condition worsens, you should immediately seek medical help.

Mantoux sometimes gives the following reactions on the first day:

• slight redness;
• slight swelling;
• itching

All this is the body’s normal response to tuberculin; by the evening the unpleasant symptoms disappear

It is important not to allow your child to scratch the injection mark. Skin damage can lead to inflammation

And this will not only interfere with the correct assessment of the results, but will also greatly harm the entire body. It is forbidden to smear the Mantoux mark with antiallergic ointments and alcohol solutions to reduce itching and redness - it will become even worse, and the results will ultimately be distorted.

Mantoux on the second day

On the 2nd day, Mantu should be moderately reddened and slightly dense, about 1 cm in diameter. When pressed, the papule is painless and turns white. During the day, the boundaries of the compaction become blurred and the redness goes away. By the evening of the 2nd day or the beginning of the 3rd day after the tuberculin test, the irritation from the injection completely disappears and only the true reaction to the injected drug remains.

Mantoux on the third day

Mantu on the third day should be almost invisible. A barely visible trace of Mantoux is considered normal; the speck should not exceed 2 mm in size. A slight bruise is acceptable if the drug was administered by an inexperienced nurse and the injection technique was slightly violated.

Symptoms that indicate a positive or false positive reaction:

• redness more than 5 mm;
• compaction;
• rashes around the injection site;
• severe swelling of the arm and body;
• heat.

Along with external symptoms, the child’s age is assessed. The results of the current sample are compared with last year's. The difference between the sizes of the papule is assessed; the larger the deviation, the more alarming the situation.

Conclusion

In order for the mantoux mark to heal as quickly as possible, you must follow the recommendations of the doctor who administered the vaccination. It is necessary to limit the contact of the papules with water, since tap water can wash out the composition and the result will be false negative. In addition, the child needs to be protected from allergens such as citrus fruits and sweet water. When the papule measurements are taken, you can return to your normal diet.

After trying mantu, the child may experience a slight increase in temperature, some lethargy and drowsiness, and a slight loss of appetite. If the symptom is itching all over the skin, swelling of the nasopharynx or urticaria, then an allergy has occurred to the drug. To ensure that side effects do not occur, the mantu test should only be done on healthy children; it is prohibited from doing it for influenza, ARVI, sore throat and other active diseases. If, after trying mantu, a child feels very tired and refuses to eat, this is a reason to consult a doctor as soon as possible.

In general, if the papule does not cause concern to the child and does not interfere with his life in any way, there is no need to panic. Even heredity plays a big role in this; remember the mother and father of the child and their reaction to manta rays. To reassure yourself, you can consult a phthisiatrician who will either confirm your fears or dispel them.

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What to do if papules from Diaskintest come into contact with water?

Diaskintest is a laboratory test similar to Mantoux, which is worth doing to identify the body’s immune response to the presence or absence of tuberculosis bacilli in the blood. The procedure for carrying it out is the same as for Mantoux: the necessary reagent is injected into the forearm, and the results are assessed after three days.

This is due to the fact that the method of this test involves the use of special proteins that cause a reaction of the body’s immune system to mycobacteria only tuberculosis. Compared to Mantoux, Diaskintest also allows you to detect the activity of these pathogenic microorganisms.

The place where the Diaskintet test was placed may accidentally get wet, and there is nothing to worry about. But it is best to inform your doctor if water has come into contact with the sample. This is necessary for further consideration of this factor when assessing the results. Otherwise, this may distort the results obtained.

When performing water procedures, you need to remember some restrictions that should be taken into account after performing Diaskintest for three days:

• Do not scratch or rub the sample site;
• Do not apply any cosmetics or detergents to this area of ​​skin.

Although it is not recommended to swim after trying Diaskintest, it is important to follow all the above rules. Then the result will be as reliable as possible, and its decoding will be the most accurate

When wondering what will happen if you wet Mantoux, it is important to understand that excessive exposure of water to the site of Diaskintest and Mantoux can lead to the protective crust on the wound becoming wet, which can lead to tissue infection. As a result of the inflammatory process, a false positive result may occur, which, when deciphered, may be mistaken for the presence of the tuberculosis virus in the body

As a result, additional examinations and re-testing will have to be carried out.

https://youtube.com/watch?v=n0vGFmhZA7s

How to correctly measure Mantoux for a bruise?

Mantoux is checked with a rigid transparent ruler. It should be remembered that a false reaction may occur (both negative and positive). When the papule turns blue, it may appear even larger.

In some cases, if there is a bruise at the site of the mantu, this can lead to the formation of an abscess filled with purulent contents. The symptoms of this abscess will be a thick swelling and throbbing pain. It is not recommended to self-treat an abscess. You should immediately consult a doctor who will provide treatment in two ways:

• prescribe the use of antiseptics (Miramistin, Vishnevsky ointment, Ichthyol ointment);
• surgical opening of the abscess.

A blue papule after mantoux may indicate damage to the nerve endings in the skin. This complication occurs in 5% of 100 cases. In order to cure it, B vitamins are used.

Normal Mantoux results and deviations

Redness and rashes that were caused by antigens are the body's reaction to the allergen. Therefore, doctors always warn that parents should talk in advance about the fact that the baby is allergic before vaccination. Otherwise, the reaction to the introduction of a tuberculin test may intensify.

The antigen is administered with extreme caution to epileptics, as well as people with skin diseases. Despite the fact that their body’s reaction can be very strong, it will not always mean they are infected with tuberculosis

The following reactions to a tuberculin test are distinguished:

1. Hyperergic. In this case, the mantu reaches 1 cm 7 mm. This reaction indicates that the child has recently had an infection or is suffering from tuberculosis.
2. Positive. From 5 to 16 mm, which indicate that the baby has immunity from tuberculosis.
3. Doubtful. The mantoux on the arm takes up to 4 mm and there is slight redness at the site of the vaccine.
4. Negative. In such a situation, there is a seal that takes up no more than 1 millimeter. In addition, a negative mantoux test may indicate that the child is not immune to the disease.

If, after examining the hand, the doctor does not like the reaction to the tuberculin test, the child is referred to a phthisiatrician. This specialist treats tuberculosis. You need to know that sometimes even a hyperergic reaction is not a consequence of the disease. A positive reaction does not mean that a child has tuberculosis. To confirm the diagnosis, doctors perform another test.

Also, if there are any deviations from the norm, the children are registered at the dispensary. Depending on the results after a new test, the child is removed from the register or treatment is prescribed. The conclusion that the baby is not infected is based on the papule, which has retained the same size as before

In addition, during the repeated examination, the phthisiatrician will pay attention to the papule that accompanies the vaccination site