Mantoux test is conducted annually among children. For the first time in the form of a tuberculin reaction Pirke was used in the early 20th century. Mantoux (r.Mantu - after the French doctor who proposed it) is a modification reaction Pirke. In Russia, this kind of tuberculin held since 1965.

What is the Mantoux test

The incidence of tuberculosis is sufficiently high throughout the world, including in our country. However, childhood tuberculosis in Russia are rare thanks to the timely detection and treatment of this disease. Detection of tuberculosis in children Tuberculosis in children - Actual problems of modern   due to the fact that, penetrating into the organism Mycobacterium tuberculosis cause sensitization (allergy) body. Allergies to identify Mycobacterium tuberculosis using Mantoux test, which is carried out by intradermal tuberculin - extract (lysate) from Mycobacterium tuberculosis, heat-killed.

Reaction to Mantoux, a child may be different depending on the time that has elapsed since the BCG, and possible infection. On the third day after setting the Mantoux test at the injection site may occur a slight thickening of the skin - a papule. It is measured and evaluated. In order not to confuse the papule with reddening of the skin, it pressed against a transparent ruler - papule becomes white and has a clear edge. Measure the transverse dimension of the papules without taking into account its surrounding redness. Redness is recorded only if there is no papules.

Evaluation Mantoux test in children

When checking the Mantoux test is assessed on strictly defined criteria:

• r.Mantu negative - a complete lack of infiltration (papule) at the injection site or a trace of infiltration injections with no more than 1 mm;
• r.Mantu questionable - infiltrate the size of 2-4 mm, or only redness of any size without infiltration;
• positive r.Mantu - infiltrate a diameter of 5 mm or more infiltration or growth with respect to the last year more than 5 mm (increasing r.Mantu); weakly positive r.Mantu - infiltration of 5-9 mm, medium intensity - 10-14 mm, expressed - 15-16 mm;
• hyperergic (expressed excessively) r.Mantu - infiltration of 17 mm or more, or vesicles, necrotic (with the formation of vesicles and necrosis) reaction, regardless of the size of infiltration, lymphangitis and lymphadenitis Lymphadenitis - when inflamed lymph nodes   (inflammation of the adjacent lymphatic vessels and lymph nodes), child screenings (the emergence of several hotbeds around the main, parent).

Normal Mantoux children

What a r.Mantu considered normal in children? Normal reaction may be different, depending on the time elapsed from the date of vaccination against tuberculosis (BCG), which is conducted for all children in the hospital, as well as the size of the hem, the remainder of the vaccination:

• 1 year of life, or one year after BCG - the norm is the quantity of infiltration after r.Mantu 5-15 mm (if after BCG scar was equal to 6-10 mm) or 5-11 mm (BCG scar from 2-5 mm);
• 2 years of life - Mantoux test rate in children, if the size of the infiltrate remained unchanged or slightly decreased compared to last year; the value of BCG scar does not matter;
• 3-5 years of life - the size of infiltration is reduced and does not exceed 5-8 mm;
• 6-7 years of life - fading reaction to the doubtful or negative.

Bad Mantoux test a child

"Bad" r.Mantu - is a relative term. Since almost all TB-infected adult population, it is set to the time of the introduction of the organism Mycobacterium tuberculosis, ie tubinfitsirovanie. Moment tubinfitsirovaniya accompanied superelevation r.Mantu, that is, its growth compared to the previous figures. It says that under unfavorable conditions (fatigue, malnutrition, frequent stress and so on), a child may develop TB Tuberculosis - a full recovery is not guaranteed .

A sign of turn shall be considered:

• the appearance of the first positive r.Mantu (infiltration of 5 mm or more), though it was negative or doubtful;
• previous amplification reaction by 5 mm or more;
• hyperergic reaction (infiltration of more than 17 mm) irrespective of the limitations of vaccination;
• r.Mantu kept at more than 12 mm after 3-4 years after BCG vaccination.

If you suspect an infection should first eliminate all factors that could affect the r.Mantu. It is an allergy to the components of tuberculin or to any other substances, which contacted the child, recently transferred disease, the introduction of a vaccine a month ago and so on.

The child, who was identified turn fully examined in order to eliminate the disease of tuberculosis, being treated with anti-TB drugs and watch for a year.

Mantoux test in children is very important. Due to its systematic, it is possible to prevent and promptly identify cases of childhood tuberculosis.

Galina Romanenko

Every mother knows about the existence of the so-called childhood diseases, and that they are accompanied by a rash. But what is an infection, and what happens at each of these rashes, do not know everything. Children infections transmitted by airborne droplets, and have a high index of contagiousness -that is in contact with the patient the risk of disease is very high.

The rash of varicella (chickenpox)

The rash of chickenpox Chickenpox - not just a childhood disease   It characterized by false polymorphism: simultaneously on the child's body may be different elements - spots, papules, vesicles, pustules and crusts. In fact, it is the transformation of chicken pox rash.

During the first three - four days, there are always new elements rash. They look like pink spots three to five millimeters in diameter. During the day spots are transformed into papules are raised above the skin, and then on top of papules appear bubble - it turns into a vesicle. A day later the contents of the vesicle becomes cloudy, it becomes pustules. Then the vial is opened, dries up, covered with crust. It turns out that on the fourth day of the beginning of the rash on the skin will be all of these kinds of rashes.

The intensity of the rash may be different - from a few to hundreds of elements, beyond the bank. Rash localized uniformly over the entire surface, including the scalp and mucous membranes. Make sure that the child is not combed rashes, for the prevention of infection.

The rash of measles

The rash of measles Measles in children - may cause serious complications   It looks quite different. At first the baby runny nose, sore throat, cough, watery eyes. Very annoying bright lights, so these children like a darkened room, closed the curtains. The rash appears on the background of the high temperature, it appears as red spots.

The spots appear at first behind the ears, on the face and neck, then three days later descends, spreading throughout the body. Spots slightly raised above the skin, tend to merge. But it is always possible to find areas of intact skin. Gradually the spots darken and disappear in the same sequence in which appeared.

The rash of rubella

The rash of rubella Rubella - it is better to be vaccinated   very similar to measles. It also appears behind the ears, face and neck, then within three days down below. It looks like the rash of pink spots, but with no tendency to merge. Do not leave pigmentation disappears without a trace on the third - the fifth day. The general health of the child are usually not affected, which is a characteristic difference from measles.

The rash of scarlet fever

Disease begins acutely, with the increase in body temperature to febrile digits. The child complains of, first of all, the pain in my throat.

The rash is quite characteristic - it looks like a small pink dots on a background of reddened skin. The rash on the face is condensed, in the natural skin folds and side surfaces of the body.

Characterized by a pale nasolabial triangle that emphasizes bright gipermirovanymi cheeks. Zev is characterized as flaming. The language that initially thickly coated with white bloom, with the third - the fourth day starts to be cleaned, it is bright red, with shiny hypertrophied papillae. Such language is called crimson.

Skin rash lasts up to a week, then disappears, leaving no pigmentation. After two weeks, there is a plate-peeling on the entire body, including the palms and soles.

Thus, when a rash of childhood infections and is characterized by quite a lot of features. But, unfortunately, there are many forms of the course of diseases, among which there are atypical and erased. Therefore, the dynamics of the rash may be different from the classical and be difficult to diagnose.

Svetlana Shimkovich