The Mantoux Test

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The Mantoux test or tuberculin sensitivity test is performed to check if you have been infected with TB bacteria and see how your immune reacts to the bacteria. 

The tuberculin test is done by placing a certain amount of TB protein (antigen) under your arm. The reactions may vary from person to person. 

If you have been infected with the infectious bacteria called mycobacterium tuberculosis — which is a TB bacteria — your skin may have a red bump that has been tested within 2 days.

The transmission for TB disease can occur air-borne. For example, if you have TB and you cough without your mouth closed, the bacteria will spread through saliva — which is then inhaled by the people around you. TB disease does not only affect adults but also children.

PDD is a TB antigen used in tests for tuberculin or purified protein derivatives. Your doctor will inject PDD under the top layer of your arm to see the reaction and perform analysis. This is the best way to indicate TB infection. However, this test cannot determine how long you have been infected with this test.

How A Mantoux Test Works 

The Mantoux test is done by injecting the PPD substance tuberculin, into the skin layer of your arm. Wait a few moments for the skin to react. If you have previously been infected with TB bacteria, you will see red bumps on your skin surface as a reaction to the test.

Your doctor will mark around the area of ​​the red bump using a marker. The goal is to help your doctor identify if the bump experiences any changes after a few days. About 48 to 72 hours after the Mantoux test is done, your doctor will examine the red bumps. 

If the bump is not enlarged, it can be concluded that the Mantoux test result is negative or that you are not infected with TB bacteria. Meanwhile, if the bump is enlarged and inflamed, the test result may come back positive or that you are infected with TB bacteria. If the tuberculin test result comes back positive, your doctor will advise you to do further tests to confirm the TB bacterial infection in your body.

Cost Estimation for Mantoux Test

The cost for a Mantoux test may vary — depending on your choice of hospital. 

For more details regarding cost estimation for a Mantoux test procedure. contact Smarter Health

Pre-Mantoux Test

No special preparations are required for a Mantoux test. However, it is recommended that you: 

  • Tell your doctor that you have had a positive Mantoux test with PPD. This way, you do not need to have another tuberculin test, unless something unusual occurs.
  • Tell your doctor if you are taking certain medications, such as medicines that affect your immune system. This can lead to less accurate tuberculin test results. Make sure to consult your doctor first.
  • Tell your doctor if you have received the BCG (bacille calmette-guerin) vaccine while you have a Mantoux test.

During Mantoux Test

Your doctor will ask you to remain seated and raise your inner arm. Your doctor will clean the puncture site using antiseptic and let it dry. After that, your doctor will inject a TB antigen or PPD substance under the top layer of the skin. Then, your skin will react by the appearance of red bumps. Your doctor will circle the bump using a marker and wait 48 to 72 hours.

Post-Mantoux Test

You can return home and come back after 2 to 3 days. If you have waited several days, you can come back to the hospital where you have the Mantoux test. Your doctor will check your bumps to see any changes. Size changes in the bumps will show different results.

Understanding Your Test Results

You should not hesitate to ask your doctor to explain the results of your Mantoux test. If you only experience redness in the puncture site, then you are not infected with TB infectious bacteria. However, if you have red bumps, it is possible that your body is infected with TB infectious bacteria. Your doctor will consider whether you have the potential to have TB from the puncture site where the red bumps appear. 

Later, the analysis will be divided based on whether you have the potential to be infected with TB. Here are three levels of TB risk you need to know:

  • High risk — people who have HIV; people who regularly interact with active TB sufferers; people who have TB symptoms; and people who have indications of TB after having a chest X-ray.
  • Moderate risk — people who have recently moved or relocated to a country that has a high rate of TB cases; people who take illegal drugs using injections; people who work in hospitals; people living in nursing homes; homeless people; and people who regularly interact with active TB sufferers
  • Low risk — people who do not have TB symptoms and do not interact with TB sufferers.

If you are considered a high-risk, a red bump that appears on your skin is considered a sign that you are infected with TB. However, if you are a low-risk type, you will need to have larger, red bumps to be diagnosed with TB disease.

To understand the results of the Mantoux test, you should know the difference between normal and abnormal results:

  • Normal result (negative): There is no red bump in the puncture site or the bump is only smaller than 5 mm. However, a 5-mm bump may indicate an infection in people who are at high risk. 
  • Abnormal result (positive): A 10-mm red bump appears in the puncture site. This condition indicates the presence of TB infection in people who are at moderate risk. Meanwhile, a 15-mm red bump indicates a TB infection in people who are at low-risk

Your doctor may recommend further tests to get more accurate results, such as chest x-rays and sputum culture test to confirm if you have TB 

Side Effects of Mantoux Test

In general, the Mantoux test does not have significant side effects. There is also a very small risk of severe reaction, such as swelling and redness in the puncture site. 

This reaction may appear, especially in people who have tuberculosis or have been previously infected as well as in people who have previously been injected with the BCG vaccine. Allergic reactions are also rare complications.

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