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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] Use of two-step testing is recommended for initial skin testing of adults who will be retested periodically (e.g., health care workers).
The Mantoux skin test is used in the United States and is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention . [citation needed] If a person has had a history of a positive tuberculin skin test, another skin test is not needed. [citation needed]
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 ...
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.
In addition, the discovery of the tuberculin skin test paved the way to the world's understanding of many other mycobacterial infections as well as certain fungal infections. [13] Coupled with that, there has been more profound research and discoveries on the immune systems of humans and animals as the idea of skin testing broadened.
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.
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
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]