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This initial skin test, though negative, may stimulate (boost) the body's ability to react to tuberculin in future tests. Thus, a positive reaction to a subsequent test may be misinterpreted as a new infection, when in fact it is the result of the boosted reaction to an old infection. [22]
The medical history includes obtaining the symptoms of pulmonary TB: productive, prolonged cough of three or more weeks, chest pain, and hemoptysis.Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to purulent. [1]
The tine test is a multiple-puncture tuberculin skin test used to aid in the medical diagnosis of tuberculosis (TB). The tine test is similar to the Heaf test, although the Mantoux test is usually used instead. There are various forms of the tine tests which usually fall into two categories: the old tine test (OT) and the purified protein ...
IGRAs may increase sensitivity when used in addition to the skin test, but may be less sensitive than the skin test when used alone. [110] The US Preventive Services Task Force (USPSTF) has recommended screening people who are at high risk for latent tuberculosis with either tuberculin skin tests or interferon-gamma release assays. [111]
Nodules and fibrotic scars may contain slowly multiplying tubercle bacilli with the potential for future progression to active tuberculosis. [1] Persons with these findings, if they have a positive tuberculin skin test reaction, should be considered high-priority candidates for treatment of latent infection regardless of age.
The equivalent Mantoux test positive levels done with 10 TU (0.1 mL 100 TU/mL, 1:1000) are 0–4 mm induration (Heaf 0-1) 5–14 mm induration (Heaf 2) >15 mm induration (Heaf 3-4) The Mantoux test is preferred in the United States for the diagnosis of tuberculosis; multiple puncture tests, such as the Heaf test and Tine test, are not recommended.
Tuberculin skin test. Tuberculin skin test (purified protein derivative [PPD]) results are positive in 84–95% of patients with Pott disease who are not infected with HIV. A girl from Oklahoma, who has been affected by bone tuberculosis, 1935. Radiographs of the spine Radiographic changes associated with Pott disease present relatively late.
Negative reaction to tuberculin skin test 2: TB infection No disease: Positive reaction to tuberculin skin test Negative bacteriologic studies (if done) No clinical, bacteriologic, or radiographic evidence of TB 3: TB, clinically active: M. tuberculosis cultured (if done) Clinical, bacteriologic, or radiographic evidence of current disease 4: TB