Negative reaction to mantoux. No Mantoux reaction in a child: is this normal? What it is

Tuberculosis is a dangerous infectious disease. Both adults and children participate in the comprehensive state program for its prevention and early diagnosis.

All newborns are graft BCG. It protects the child's body, which is not yet strong, from the first days of life. Starting from a year old, children pass annual Mantoux test procedure.

The test shows how successfully immunity against a dangerous disease is formed in a growing organism. With its help, the diagnosis of tuberculosis infection is also carried out.

Children receive a second BCG vaccination V primary school . It provides protection for another five to seven years. The effectiveness of vaccination is again monitored using Mantoux, the result makes it possible to find out if infection has occurred within a year.

After coming of age, Mantoux is replaced by another mandatory procedure - fluorographic study. Adults are required to take it every two years (or once a year, if the nature of their work requires it).

Tuberculosis is not always localized in the lungs, and the adult Mantoux test is used as a additional tool diagnostics. It is carried out after contact with the carrier of the infection, to diagnose latent forms of the disease. The lack of response to tuberculin in adults suggests that the patient is not ill with tuberculosis.

Signs of a positive and negative reaction

When conducting a Mantoux test under upper layer skin injected minimal ( 0.1 mg) the amount of tuberculin preparation made from tissue fragments of tubercle bacillus. The material is processed thermally and chemically, the sample is harmless and easily tolerated by the body. The reaction to the injection on the first day is manifested hyperemia(redness) and thickening of the tissues around the injection site. This seal is called papule, its size and character are the main diagnostic features samples.

Photo 1. Papule size 0.7 mm after passing the Mantoux test.

Negative reaction for a Mantoux test - complete absence of tumor and redness around the injection site. The result is checked on the third day after the test was made ( after 72 hours). Slight redness (especially on the thin skin of a vaccinated child) and slight induration ( up to 2 mm) can be equated to a negative result, taking into account other signs (good health, absence of symptoms, favorable situation with morbidity in the region).
Papule from 2 to 4 mm considered an indicator dubious reaction. Infiltrate from 5 to 16 mm in children and two centimeters in adults - positive result Mantoux test.
Papule from 17 mm in children and 21 mm in adults - hyperergic(pronounced) reaction. If it is accompanied by additional characteristic features (color, shape, firmness, skin changes), then it indicates a tuberculosis disease.

There is no reaction to Mantoux in a child, what does it mean, why does this happen

In children, a complex principle for evaluating the results of the test has been adopted.

In the first year of life, after the introduction of the BCG vaccine, the body enters the fight against infection, creates immunity against tuberculosis. The injection site may fester, then it forms on the child's skin scar. The size of the scar after BCG is an important indicator. If for some reason the scar has not formed, is not noticeable and is not palpable - the vaccination had no result, it is necessary to do it again. In this case, an uninfected child will have a negative reaction.

Attention! Negative reaction to the Mantoux test in a one-year-old child who was vaccinated with BCG, is not the norm. It is natural only if there is no scar. In other situations, additional diagnostics are required. The reason for the lack of response can be both the child’s immunity that has not yet been formed due to the young age, or diseases that can destroy this immunity (for example, HIV).

small scar ( about 2 mm) suggests that there was no significant stress on the immune system in the child’s body before the age of one. Enough protection against infection for two years, then the immune system will “forget” the signs of the pathogen, the reaction to the Mantoux test will become negative. The decision on the need for re-vaccination, after consulting with the parents, will be made by the doctor.
Average scar after BCG ( about 5 mm) will provide better protection. In this case, the Mantoux reaction per year will be about 5 mm and becomes negative 4-5 years old. But this is not necessary either. It is possible that the Mantoux index for all subsequent checks will be within the limits of weakly positive ( 5-7 mm) or doubtful ( 2-4 mm) reactions. The main thing is that with each check before the secondary vaccination, the figure consistently decreases.

A particularly alarming sign is a negative Mantoux reaction in a child vaccinated at the maternity hospital at the age of two.

By the end of the second year of life, the value of anti-tuberculosis immunity after vaccination becomes maximum. With a large scar ( 8 mm - 1 centimeter) the sample size reaches 16 mm.

Average rate approx. 10 mm. A negative reaction with a normal scar (and a previous result corresponding to the norm) must be checked additionally. Perhaps a disease associated with a general disorder of immunity.

By the age of three the Mantoux reaction begins to weaken in everyone. Part of the tested children (with a scar size of not more than 3 mm) will show a negative reaction. IN 4-5 years the number of children with a negative result will increase, the average indicator of the norm will remain a weakly positive reaction.

By the age of six a negative (or dubious) reaction will already be shown by most children.

After revaccination, the reaction to Mantoux in children should remain positive for at least 5 years ( up to 12 years respectively). The main indicator in its evaluation is the size of the scar. Successful vaccination and a normal scar result in long-term protection.

Reference. Before re-vaccination at age seven years old the normal indicator when checking the results of Mantoux becomes negative. She says that the child is not infected with tuberculosis. The immunity developed by the first BCG vaccination expires by this time.

Only by 13-14 years old negative Mantoux reaction is again becoming the norm. If immunity has expired earlier, the doctor may recommend a second vaccination.

No trace of Mantoux in adults

The Mantoux test is used as a means express diagnostics if the patient is suspected of an open form of tuberculosis, if contact with a carrier of the infection has occurred recently, if symptoms are present and concern about the possibility of infection. The only normal, removing most questions will be backlash, after the test, no compaction or redness should be visible.

Photo 2. Negative reaction to the Mantoux test.

Any reaction, any trace of an injection, including redness, becomes the subject of evaluation and research in the diagnosis of unvaccinated patients.

Important! When diagnosing infection or disease with tuberculosis, the diagnosis never placed based on the Mantoux test alone. Additional tests and a comprehensive study are prescribed at the slightest doubt that the reaction to tuberculin is negative.

indicators questionable result at diagnosis, there will be any redness and any size of the tumor. Perhaps the infection has occurred recently, you can not miss it.

False negative results when checking the Mantoux reaction, it is assumed in cases where the body of a person who has long been ill with tuberculosis no longer responds to a diagnostic drug. In these cases, the signs of the disease are usually present, the complex of analyzes rarely includes a tuberculin test.

Tuberculosis often occurs against the background of a general disorder of the immune system. In this situation, a negative reaction to tuberculin is not an accurate diagnostic indicator.

Reduction of papule in children (up to a false negative reaction) occurs after taking antihistamines that can reduce the manifestations of "post-vaccination allergies". If infection is present, the reaction will still remain positive.

Achieving a "negative Mantoux reaction" is unreasonable, any manipulation of the result dangerous And make the process pointless.

Who should not do the test: its possible complications and contraindications

Complications after the Mantoux test are associated with violation of the technology of its implementation(damage to the skin, infection and associated fever). Properly performed procedure is safe for healthy person who has undergone a preliminary examination by a therapist.

The Mantoux test is not given to patients with certain diseases ( epilepsy, asthma, skin diseases). It is not carried out at high temperature, in the acute stage of any disease, with digestive disorders, poisoning, respiratory diseases.

Allergy to the components of the diagnostic drug itself (primarily to phenol, used in small quantities as a preservative) is rare, but may be a reason for sample rejection.

Performing a procedure on a person whose immunity has not recovered after any illness(not only infectious), as well as earlier than four to six weeks after the next vaccination, can change the negative result of the test to doubtful and even positive, requiring additional verification.

How not to spoil the size of the "button"?

So that the procedure for checking the Mantoux reaction does not drag on for many months and shows the exact result on the first try, take the time to careful preparation for it..

One week before doctor visit eliminate from the diet products that can cause you allergies, containing preservatives and other additives, as well as unnecessary medicines. Be sure to undergo an examination by a therapist, if you feel unwell, get a medical tap.

Clothes for the injection visit should be comfortable, spacious, natural materials(cotton), without wool and lint.

injection site do not overheat, scratch or rub, cover with plaster or treat with medicines.

After the injection and before the second visit to the doctor continue to take care of yourself and the sample, observe the diet, try not to overwork and not get sick. You can go through the Mantoux test procedure at the local clinic, tuberculosis dispensary or private medical center, where you will be provided with more individual approach and quick access to additional research methods.

A tuberculin test is done in order to determine whether the child's body is able to fight against the causative agent of tuberculosis. A negative Mantoux reaction is a good sign, but is not considered a de facto exception to the presence of an infection in the body. Vaccination should be taken very seriously!

The most important thing about the sample

The Mantoux test is a preventive procedure for the prevention of tuberculosis. A tuberculin test is done to children of the first year of life and is then carried out annually.

The vaccine is based on tuberculin, an artificial preparation containing the waste products of the virus. Such a drug works on the principle of an indicator: if the body reacts very violently and characteristics this will help to take preventive measures in time.

It is important for parents to know that BCG must be given before the first Mantoux vaccination. BCG vaccination helps to activate the immune system and produce antibodies against tuberculosis infection. The results of the Pirquet test are also closely related to such a vaccination, since both of them are aimed at strengthening the protective mechanism in children.

A reaction test is always done three days after the vaccine is administered to the child. Sometimes it is not enough to know only the result of the current vaccination. We need all tests for tuberculin for previous years, which will be studied in a complex.

Reading the results of the reaction to the Mantoux test in children is carried out with a soft ruler with a clear scale. The size of the papule and redness at the injection site must meet certain standards. There is a special table of the size of the reaction to vaccination, according to which the data obtained are verified.

There are certain contraindications for the tuberculin test that you need to know about before vaccinating. If children have signs of allergy or individual intolerance to the vaccine, epilepsy, skin diseases, then the vaccine should not be given. During a chronic illness or respiratory infection vaccination is also contraindicated. The Pirquet test can be performed only one month after the child has fully recovered.

You should also be aware of what can affect the result of the vaccination and what should not be done before the examination:

Be sure to know if the child has had other vaccinations recently. Mantoux does not interact well with other vaccines and this may affect the result. Therefore, you should make an interval between vaccinations of at least a month;
Tuberculin test should not be wetted with water, hydrogen peroxide or other liquids;
For three days, it is strongly not recommended to smear with anti-inflammatory drugs, scratch or wrap the surface of the skin at the injection site.

Of course, you can bathe children, no need to neglect personal hygiene. If you are going to bathe the baby, then this should be done in the bathroom. The injection site should not be rubbed with a washcloth. After bathing, it should be lightly blotted with a soft towel. But swimming in the river or in the sea is not allowed.

Many parents believe that the introduction of tuberculin into the body of their children is dangerous and can only do harm. In fact, the Mantoux test is designed to stimulate the child's immune system. The body will have a hard time resisting strong new viruses if there are no antibodies in the blood. The vaccine does not pose a serious threat to the health of the child and is not considered dangerous..

Parents can refuse to vaccinate their children, this is not prohibited. But it should be remembered that a disease such as tuberculosis can have very serious consequences, and preventive methods should not be neglected!

What does negative reaction mean?

A negative reaction in a child is characterized by the absence of a papule under the skin. If a “button” has formed, then its dimensions should not exceed 1 mm in diameter. This is considered a good indicator.

But this result can be interpreted in different ways. A negative Mantoux test means that the body did not show any reaction. The natural causative agent of tuberculosis did not get into the blood, and therefore the immune system ignored the vaccination. There is an opinion that when such a result is obtained, children have a certain immunity to the causative agent of tuberculosis. This means that the immune system is resistant to this virus, which is very good.

But there is another opinion - a negative reaction to the Pirke test shows that the body is poorly prepared to fight infection and the child's immunity is weakened. This is characterized by the absence of an active accumulation of lymphocytes at the site of the vaccine. The volume of lymphocytes affects the size of the papule under the skin. Accordingly, for some doctors, this means that the baby has a predisposition to tuberculosis, since the protective mechanism is poorly developed.

It should be noted that some children may have a false negative reaction to the tuberculin vaccine. This means that there may be a tuberculosis bacillus infection in the body, but the result will be negative.

This reaction can occur for several reasons:

if the children have been infected with tuberculosis in the last few weeks. It is necessary to re-vaccinate after 10 weeks, eliminating possible infection factors;
due to the small age, the child's body with a slowdown begins to counteract. It also affects the lack of development of immunity and its instability;
anergy - the immune system is not able to provide proper resistance to tuberculin mycobacteria. This is due to various violations of the immune system, the disease on AIDS. In this case, additional diagnostics and a Mantoux test with a higher content of tuberculin are needed.

Do not rely solely on the result of tuberculin vaccination. Mantou has established itself as effective remedy prevention of the disease, but does not give a 100% guarantee of the accuracy of the diagnosis.

Cases for referral to a TB dispensary

If a child was sent to a tuberculosis dispensary, then this is not a reason for panic. A referral does not mean that children already have TB. Perhaps additional diagnostic methods are needed, since it is difficult to make an unambiguous answer according to the Mantoux reaction. Tuberculin vaccination is one of the indicators and ways to detect infection. Medicine is not limited to this. As an additional diagnosis, children will need to undergo some procedures: fluorography, blood and urine tests, sputum culture. The final result can be obtained after analyzing all the data.

A child can be referred to a tuberculosis dispensary with both a positive reaction to Mantoux and a negative one. You should visit a tuberculosis dispensary for additional diagnostics if a baby at 2-3 years old had a negative result on Pirk, and every next year the papule increased by 2 mm. So the negative reaction acquired signs of a positive one. This direction can be obtained by children and adults. Do not neglect your health and postpone visiting doctors.

Video "Mantoux test"

Video about the Mantoux test and the body's reaction to it.

Let's start with what this test is for and what it is all about. Tuberculin is introduced into the body and a reaction to the introduction of this drug is observed. This is the only way to determine predisposition child's body to this dangerous disease. The reaction of the body can be called a kind of allergy. In the place where the drug was injected, redness should occur - a kind of inflammation caused by blood cells that are responsible for immunity at the cellular level. What does the term "positive reaction" mean? The inflammation is greater than that caused by the injection itself. Redness (papule) is measured with a ruler. According to the diameter, they determine whether the reaction is positive, or whether Mantoux is the norm. By the way, tuberculin itself is not an antigen, it is rather an allergen.

How is the Mantoux norm assessed in children? Two or three days after the administration of the drug, a specific rounded, reddened seal appears on the skin. Evaluation is carried out after 72 hours, starting with an external examination. In this case, it is possible to establish both the absence of a reaction in general, and hyperemia, or infiltrate. It is important to distinguish hyperemia from infiltration. Palporno determines the thickness of the skin fold over the area of \u200b\u200bhealthy skin, then - at the injection site. The skin fold during infiltration thickens, as in a healthy area, the same way. Then comes the measurement and registration of the size of the infiltrate. To do this, you need a millimeter transparent ruler. "Handy materials" for this purpose are unacceptable. Be sure to follow how the evaluation of the test result will be carried out. It should be done in a bright room, only with a transparent ruler and only by a specialist! Only the size of the seal is to be measured. Reddened skin near the seal is not a sign of immunity, or infection.

Now in more detail about what it means: "Mantoux is the norm." The sample is considered negative when the papule is completely absent and the prick reaction is from 0 to 1 mm. With such indicators, Mantoux is the norm. If the size of the infiltrate is from 2 to 4 mm, with redness and increased blood supply to the tissue, the sample is considered doubtful. In the case when the infiltrate is 5 mm or more, the reaction is positive. This is a cause for alarm, but not for panic, since the sample does not serve as evidence of tuberculosis. The following points are indicative of danger:

annual increase in sensitivity to the sample;
a sharp jump with an increase of 6 mm or more;
stay in the zone of increased circulation of tuberculosis (even short-term);
contact with a patient with tuberculosis (even a short one).

In these cases, the child should be referred to a phthisiatrician.

A weakly positive reaction is considered when the size of the infiltrate is from 5 to 9 mm;
average intensity - from 10 to 14 mm; pronounced - from 14 to 16 mm, hyperergic 17 mm and more.

In a small child at two or three years old, a positive reaction to the introduction of tuberculin may well be a post-vaccination allergy. The reaction depends on the reactivity of the individual and a year and a half after BCG can be negative, doubtful, and positive (by the way, the latter is observed in 60 cases out of a hundred, according to statistics). As a post-vaccination allergy, positive reactions develop after 6 weeks, reaching a special intensity by two years, when the period of post-vaccination immunity is especially pronounced. Therefore, in the first year or two of a child's life, reactions to a test can "show" 5-16 mm. and a BCG scar of 4 mm indicates post-vaccination immunity up to three to four years. Mantoux is recommended for such children against the background of desensitizing agents (5 days before, 2 days after). At a positive result A visit to the phthisiatrician is mandatory. It is important to exclude any possible factors: infection, allergies, etc. If, nevertheless, the reaction caused an allergy, the child is most often sent to the PTD, for examination, having been registered. Six months later, the sample is checked. With an increase in the size of the reaction (or at the same size), the allergy is considered infectious. Reduced sensitivity indicates a post-vaccination allergy.

It's good when Mantoux is the norm. But with other indicators, you still should not panic. As a rule, additional examinations dot the "" and ", refuting the presence of tuberculosis in the child's body.

A negative Mantoux reaction in children in most cases should be perceived very positively. Most often, this indicates that the child is doing well, and he is not infected with Mycobacterium tuberculosis. However, in some cases, such a result may indicate the presence of a rather dangerous pathology. None of the options should be overlooked.

When do they talk about a negative test reaction?

After the introduction of highly diluted tuberculin, which is a neutralized microorganisms, a certain reaction develops, which may indicate the presence / absence of a disease in a person. It is injected under the skin of the inner surface of the forearm with a syringe. A few days later, the child is examined nurse. She should measure the area of redness at the injection site using a flexible ruler.

A negative result is diagnosed in cases where there is no stain at the site of tuberculin injection. There is only a trace from the injection, which does not exceed 0.1 mm in diameter.

If the Mantoux reaction is negative, what does it mean? Experts disagree whether this is good or bad, or rather, whether it always corresponds to reality. The reasons for this result may be the following situations:

In order to assess exactly which reason has become decisive in the development of negative Mantoux, if symptoms of the disease are present, an additional medical examination is carried out.

If the Mantoux reaction is negative, then most often this indicates that the baby has never had contact with the causative agent of tuberculosis at all. Among other things, such a test result indicates that the child was not vaccinated with BCG or its validity period has expired.

That is, a negative Mantoux test means that the child is not infected and is completely safe at the time of the examination. However, this also means that the baby does not have immunity from Mycobacterium tuberculosis.

That is, he has an increased risk of encountering the disease caused by this pathogenic microorganism. This factor is taken into account by specialists and therefore they try to vaccinate this child with BCG as soon as possible.

What should parents and children do?

First of all, it should be understood that the negative Mantoux is not a pathological sign. In the vast majority of cases, it occurs in children who have either not been vaccinated, or simply have a reduced susceptibility to the causative agent of tuberculosis. All other options are quite rare, and most often parents know about the presence of such additional factors in advance.

If there are any doubts about the health of the baby, then you can refer him for a consultation with a pediatrician. This specialist will prescribe certain research methods that will exclude the presence of diseases.

If the reaction to Mantoux is negative, then parents should think about vaccinating the child. It will help the young body fight Mycobacterium tuberculosis in cases where it gets inside. You should not rely on the fact that the baby may never meet with such an infection. According to doctors, this pathogen occurs in 90-95% of children aged 10-12 years. So it's better to play it safe and get vaccinated.

Many today refuse to carry it out because they are afraid of infecting children with tuberculosis during vaccination. These fears are unfounded for the following reasons:

So you should not be afraid of vaccination after the Mantoux reaction in a child turned out to be negative.

It is worth remembering that acute infectious diseases are a contraindication to Mantoux. This method of research should be postponed until the child fully recovers. The point is that any sharp infectious diseases capable of giving false negative results. As a result, this leads doctors down the wrong path, which means that the child may be given additional vaccinations that he absolutely does not need.

In order to exclude the presence of acute infectious diseases that occur without severe symptoms, it is recommended to perform a general examination of patients before conducting a Mantoux test, as well as to measure their body temperature in the axillary region. If the indicators are exceeded, it is necessary to postpone the test for an indefinite period until complete recovery.

It is recommended to perform Mantu for children in winter period. This is due to the fact that in spring and autumn, children develop beriberi more often, which can cause a lack of response to the introduction of tuberculin. In summer, the skin sweats faster, and it is strongly not recommended to wet the tuberculin injection site during the study. In winter, it is much easier to avoid wetting the tuberculin injection area, and a lack of vitamins in this period is much less common.

Negative test results should not alert the child's parents. However, if there is a deterioration in the health of the child, it is better to consult a doctor.

They will help identify violations and figure out whether the child's immunity is strong enough to fight against the causative agent of tuberculosis.

The Mantoux test is one of the most popular methods for diagnosing tuberculosis. The study is carried out for all children aged 1 year and older, while the reaction to the administered drug in each baby may be different. Why does the child have a negative reaction? Is this condition dangerous? What should be the normal papule? Let's deal with this together.

What is a Mantoux test?

The Mantoux test allows you to diagnose tuberculosis. The procedure is carried out in countries where there is an unfavorable situation with this disease (this list includes Russia), and is indicated for:

diagnosing patients who contracted tuberculosis for the first time;
confirmation of the presence of the disease;
identification of persons infected a year earlier (with papule growth up to 6 cm or more);
selection of children who are planned to be re-vaccinated with BCG.

The first time tuberculin is administered to a child at 1 year old - it is forbidden to do this earlier, since the reaction to the antigen can be unpredictable. The immune system and skin of a newborn are too sensitive to various irritants, so the result may be unreliable.

The test is carried out once a year. More frequent testing may provoke an increase in the sensitivity of immunity to the drug, as a result of which the result will be incorrect. Tuberculin is administered to children under 14 years of age, regardless of how the body reacted to the previous Mantoux. So, children 6-7 and 14 years old are selected for BCG revaccination - the vaccine is given to healthy babies whose sample has a diameter of less than 1-2 mm.

Test procedure and interpretation of the result

The Mantoux test is done in hospitals and in the medical rooms of kindergartens and schools. The composition of the sample includes tuberculin - a substance obtained from Koch's sticks (pathogens) destroyed by heating.

The principle of action of the drug is to provoke skin inflammation and an allergic reaction at the injection site. The injection is done annually in the right or left hand on inside forearm. The zone is divided into three parts, the drug is injected into the middle of the central part of the forearm. The substance is injected subcutaneously with a small syringe, resulting in a small bubble (see photo).

Parents should control the baby, especially if he is 1-2 years old, so that nothing could affect the result. The resulting "button" should not be treated with antiseptics or allowed to get wet. The papule must not be sealed with adhesive tape or combed. After three days, the specialist evaluates the result by measuring the compaction with a ruler. Its value will tell about the reaction of the body:

A seal less than 1 mm indicates that Mantoux is negative - there are no mycobacteria in the body or immunity to them. Children are shown BCG vaccination.
"Button" 5-16 mm indicates a positive result. It confirms the fact of infection or contact of the patient with an infected person.
A papule with a diameter of less than 4 mm or a large red mark without induration indicates a doubtful reaction.
In the presence of an infiltrate of more than 17 mm, the reaction is considered strongly pronounced. A small patient should visit a phthisiatrician - the result may indicate both a disease and hypersensitivity to the drug, or appear against the background of a recent BCG vaccination.

There is also such a thing as a sample bend, when the reaction to the injected substance changes dramatically in the opposite direction compared to previous injections. This phenomenon indicates infection, but only if BCG vaccination has not been recently performed.

In children of different ages, the response to the Mantoux test is different:

when a child is first injected with tuberculin, the reaction to it cannot be negative (this is acceptable if there is no scar left from the BCG vaccination);
at 2 years, the size of the papule reaches 16 mm;
at 3 years, the reaction to tuberculin weakens, in some children a negative result is noted;
at 4–5 years, the number of children with a negative result increases, the average norm is a weakly positive reaction;
at 6 years old, a dubious result is detected in most babies;
after repeated vaccination with BCG, the response of the body remains positive for 5 years;
by 13–14 years of age, a negative response to tuberculin is considered the norm.

Thus, in vaccinated babies, the reaction to Mantoux varies depending on how long ago the BCG vaccination was performed - the longer the period, the less the “button”.

The result must be compared with last year. In addition, the response to tuberculin depends on the correctness of the manipulation, the characteristics of the body and sensitivity to the drug.

What does a negative reaction of the body look like?

A negative Mantoux reaction is the absence of redness of the skin around the injection and swelling. In this case, a papule with a diameter of up to 1 mm is observed, or it is not at all. A slight reddening in a child (especially a BCG vaccinated one) and a “button” up to 2 mm are also equated to a negative result if you feel well and have no symptoms of the disease.

Most often, such a reaction means that the baby is completely healthy, but there are exceptions. Sometimes a similar result indicates the absence of an immune response to the causative agent of the disease or the termination of the BCG vaccine. What a papule looks like with a negative result can be seen in the photo.

Is it good or bad if the reaction is negative?

If the child does not have a reaction to Mantoux, this indicates that the BCG vaccination was ineffective, or he already has immunity to the disease. Often the baby is sent for examination and re-vaccinated with BCG.

If a child has a negative Mantoux reaction, this may mean that his body has weakened, so he could not respond to the administered drug. It is impossible to say unequivocally whether this is good or bad - the result may indicate both the good health of the child and the presence of problems. There are several reasons why the skin does not leave a trace after the injection:

an infection has occurred, so the test must be repeated after 10 days;
the child is too small - in children under 3 years of age, a dubious, false positive or negative result is often obtained;
the baby is a carrier of HIV infection - you can increase the dose of tuberculin or do Diaskintest.

The lack of response to the Mantoux test is also possible for other reasons:

Should a child do a Mantoux test?

Parents often think about whether it is necessary to do a Mantoux test, worrying about undesirable consequences from the introduction of tuberculin. The active substance is harmless in diagnostics and does not affect immune cells, but recently there have been many children with hypersensitivity to it. Some kids quickly forget about the injection, while others get sick for a long time and complain of malaise.

Often, parents in medical institutions are frightened by the fact that the child will not be accepted into kindergarten or school if he fails a TB diagnosis, but this is not the case. Legislation secures the right for children who have not passed the test to attend an educational institution - no one can force adults to put Mantoux on a baby. Parents can write a waiver of the test at the clinic.

However, it is worth remembering that tuberculosis is one of the most dangerous diseases that can lead to death. BCG vaccination is not able to protect against infection, but prevents serious complications. Many experts consider Mantoux the only method that in almost 100% of cases helps to detect tuberculosis and problems with the immune system in time. By refusing the test, parents are risking their child's life.

If the baby inherited immunity to Koch's wand, he fell into the 2% of those lucky ones whose immune cells instantly destroy the pathogen as soon as it enters the body.

However, most children are still at risk for the disease. The test is not carried out when:

allergies to tuberculin;
asthma;
epilepsy;
the presence of a chronic disease in an acute form or quarantine in an educational institution are (temporary obstacle).

Alternatives

Today there are several alternative methods Mantoux test, including PCR analysis, blood and urine tests, as well as Diaskintest. However, none of the methods gives a 100% guarantee of detecting the disease. Diaskintest works only when infection has already occurred, and a negative result will be visible in the absence of infection or after complete recovery from tuberculosis. He does not respond to the BCG vaccine, so the need for re-vaccination with it cannot be determined.