Positive Mantoux Inoculation and Treatment

Vaccination of BCG is now mandatory. Positive reactions to the Mantoux test are possible. This may be a consequence of both infectious and post-vaccination allergies. It is recommended to determine the size and presence of cutaneous scar at the place of administration of the BCG vaccine, the time from the moment of vaccination( or revaccination), and compare them with the previous results of tuberculin samples and the size of the infiltrate.

A positive reaction to tuberculin in a child of two to three years may be a manifestation of post-vaccination allergy.

Depending on the individual characteristics of the body, after a year or one and a half after vaccination with BCG, the reaction may be negative for Mantoux, doubtful or positive - in 60% of children. Post-vaccination allergy can lead to a positive reaction and develops 6-8 weeks after the introduction of the vaccine, reaches the greatest intensity by a year or two, since by this time the immunity after the vaccine has reached a maximum. In the first 2 years of a child's life after a BCG vaccine, a positive Mantoux vaccine can reach a diameter of 5-16 mm.

If the scar is 2-4 mm, the duration of immunity after vaccination is three to four years. Such children are recommended to put Mantou on the background of taking a desensitizing agent within a week( start 5 days before and end two days after it).

If the reaction to the Mantoux test is positive, the pediatrician will refer you to a consultation with the phthisiatrician to exclude all the influencing factors: whether the BCG vaccine, other vaccines, whether the infant had recently had an infection, whether there is an allergy to tuberculin components, an allergy of unexplained etiology. If, on the basis of the findings, a specialist confirms that a positive mantle vaccination is taking place and treatment should be performed to prevent tuberculosis, he should familiarize the patient with the prescribed therapeutic procedures.

Prophylactic treatment of

In the United States, drug prevention( usually isoniazid) is usually prescribed for children under five and children who are at risk of rapid tuberculosis in contact with TB patients. Otherwise, a disease, often severe, can develop faster than a tuberculin test.

The use of the drug continues at least 3 months after the end of the contact directly with an adult patient. After a lapse of three months, a repeat tuberculin test is done. If the sample is positive, the fact of infection with tuberculosis is established, isoniazid treatment continues for another six months. With a negative repeated test, isoniazid is canceled.

Attention should be paid to two points. If the child is infected with HIV or has other immunodeficiency due to cutaneous energy, the results of the tuberculin test may be negative. These children are most susceptible to rapid progression of tuberculosis and usually doctors find it difficult to determine the timing of their infection. Such children are shown not prophylaxis, but directly treatment of tuberculosis itself.

The second situation is that the newborn has been in contact with a mother or other adult with a suspicion of pulmonary tuberculosis. In this case, the approach to treatment should be the same as for older children.

Initiate isoniazid medication and continue until the adult is excluded from tuberculosis, or until the expiration of three months after the end of contact with an adult tuberculosis patient.

Infected Mycobacterium tuberculosis children undergo medical treatment. This is the basis of modern programs to combat tuberculosis. Numerous large-scale studies have convincingly proved that isoniazid is extremely effective in preventing tuberculosis in infected children.

Isoniazid is safe, it should be prescribed to all adolescents and children with a positive tuberculin test, who have no signs of disease. The course of treatment is nine months, which is considered by most experts as the optimal time frame. Usually, isoniazid is taken home once a day. With a high risk of the disease, 2 r. A week under the control of honey. Employee, especially when there is an adult with tuberculosis in the house, undergoing treatment.

A child infected with a strain of Mycobacterium tuberculosis that is resistant to rifampicin-sensitive isoniazid is treated with rifampicin. If the strain is resistant to both drugs, experts designate two other agents.