It has been suggested that this article or section be merged with Mantoux test. (Discuss)

48-h PPD test induration being measured. Source: CDC

Tuberculin, (also called Mantoux test, currently named Purified Protein Derivative (PPD)) is an antigen used to aid in the diagnosis of tuberculosis infection. An infection with the bacterium that causes tuberculosis frequently leads to a sensitivity to these antigens. Tuberculin was discovered by German scientist and physician Robert Koch in 1890. Wikipedia does not have an article with this exact name. ... It has been suggested that this article or section be merged with Tuberculin. ... Jump to: navigation, search Image File history File links Mantoux_Test_48h. ... Jump to: navigation, search Image File history File links Mantoux_Test_48h. ... An antigen is a molecule that stimulates the production of antibodies. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ... Jump to: navigation, search Tuberculous lungs show up on an X-ray image Tuberculosis is an infection with the bacterium Mycobacterium tuberculosis, which most commonly affects the lungs (pulmonary TB) but can also affect the central nervous system (meningitis), lymphatic system, circulatory system (miliary TB), genitourinary system, bones and joints. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... Robert Koch For the American lobbyist, see Bobby Koch. ... 1890 was a common year starting on Wednesday (see link for calendar). ...

The original tuberculin discovered by Koch was a glycerine extract of the tubercle bacilli and was developed as a remedy for tuberculosis, but it was ineffective in this role. Clemens von Pirquet, discovered that patients who had previously received injections of horse serum or smallpox vaccine had quicker, more severe reactions to a second injection, and he coined the word allergy to describe this hypersensitivity reaction. Soon thereafter von Pirquet discovered the same type of reaction took place in those infected with tuberculosis, and he thus found the utility of what would become the tuberculin skin test. Glycerin, also known as glycerine and glycerol, and less commonly as 1,2,3-propanetriol, 1,2,3-trihydroxypropane, glyceritol, and glycyl alcohol is a colorless, odorless, hygroscopic, and sweet tasting viscous liquid. ... Clemens Peter Freiherr (Baron) von Pirquet ( May 12, 1874– February 28, 1929) was an Austrian scientist and pediatrician best known for his contributions to the fields of bacteriology and immunology. ... Smallpox (also known by the Latin names Variola or Variola vera) is a highly contagious disease unique to humans. ... An allergy or Type I hypersensitivity is an immune malfunction whereby a persons body is hypersensitised to react immunologically to typically nonimmunogenic substances. ...

How the test is performed

The test site (usually the forearm) is cleansed. The PPD extract is then injected into the most superficial layer under the skin, using a Tuberculin syringe, raising a blister on the skin. Because the reaction will take 48-72 hours to develop, the patient must return to the health care provider within that time for a proper evaluation of the test site. This will determine whether he or she has had a significant reaction to the PPD test. A reaction is measured in millimeters of induration (hard swelling) at the site. Jump to: navigation, search Model of the layers of human skin In zootomy and dermatology, skin is an organ of the integumentary system; which is composed of a layer of tissues that protect underlying muscles and organs. ... Jump to: navigation, search A blister caused by a second-degree burn. ...

There is no special preparation for this test. The patient should inform the health care provider if he or she has ever had a positive PPD skin test. If so, the PPD test should not be repeated. The test should also be not performed if the patient is taking some drugs, such as steroids or has a medical condition which can affect the immune system such as cancer. The PPD test may be falsely negative or the cutoffs when interpreting a reaction may be different. In chemistry and biology, Steroids are a type of lipid, characterized by a carbon skeleton with four fused rings. ... Jump to: navigation, search The immune system is the system of specialised cells and organs that protect an organism from outside biological influences. ... Jump to: navigation, search When normal cells are damaged or old they undergo apoptosis; cancer cells, however, avoid apoptosis. ...

Normal Values

A negative reaction (no induration) or a level of induration below the cutoff for each risk group may indicate lack of infection with the bacteria which causes tuberculosis. There are different cutoffs for children, for people with HIV, and other risks groups. Jump to: navigation, search The human immunodeficiency virus, commonly called HIV, is a retrovirus that primarily infects vital components of the human immune system such as CD4+ T cells, macrophages and dendritic cells. ...

Unfortunately, this is not a perfect test, and up to 20% of people infected with tuberculosis may not have a reaction on the PPD skin test. In addition, individuals with certain conditions which affect the immune system (cancer, recent chemotherapy, late-stage AIDS) may also have a false negative test result. Jump to: navigation, search Chemotherapy is the use of chemical substances to treat disease. ...

The test's significance depends on the size of the reaction on the skin and the individual. A small reaction (5 mm) is considered to be positive in individuals with HIV, in individuals on steroid therapy, or in individuals in close contact with a person with active tuberculosis. Larger reactions (greater than or equal to 10 mm) are considered positive in individuals with diabetes, renal failure and health care workers, among others. In individuals with no known risks for tuberculosis, a positive reaction requires a 15 mm or greater induration. This test is widely used. However, its limitations include the fact that there are false negatives and false positives. In addition, a positive skin test does not necessarily mean that an individual has active tuberculosis. Additional studies are needed to verify whether active disease is present. This article is about the disease that features high blood sugar. ... Renal failure is the condition where the kidneys fail to function properly. ...

Risks

There is a very small risk of severe redness and swelling of the arm in individuals who have had a previous positive PPD test and who undergo repeat testing. There have been a few cases of this reaction also occurring in individuals who have not been previously tested. Edema (BE: oedema, formerly known as dropsy) is swelling of any organ or tissue due to accumulation of excess fluid. ...

References

• Tuberculin skin test. Medline Plus Medical Encyclopedia. Update Date: 8/11/2003. By: Kenneth Wener, M.D., Department of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Maryland, USA. Review provided by VeriMed Healthcare Network. US Federal Government public domain.