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Taiwan Journal of Ophthalmology 2015The case is reported of a patient with pulmonary and ocular tuberculosis presenting with blurred vision in both eyes. A 27-year-old well-nourished male nursing-home...
The case is reported of a patient with pulmonary and ocular tuberculosis presenting with blurred vision in both eyes. A 27-year-old well-nourished male nursing-home resident with a previous history of traumatic intracerebral hemorrhage was brought to the ophthalmological clinic due to progressively blurred vision. His best-corrected visual acuity was 20/400 in the right eye with only light perception in the left eye. Fundus examinations revealed retinal segmental periphlebitis and hemorrhagic retinitis in the right eye and dense vitreous hemorrhage in the left eye. The Mantoux test was negative; however, the results of an interferon gamma release assay were positive. Ocular tuberculosis was suspected. Although he had never had any respiratory symptoms, his chest radiograph and computed tomography scan showed a multiple centrilobular glandular and ground-glass appearance with air-space consoli dations and atelectasis in both lower lobes. Pulmonary tuberculosis was confirmed by a positive acid-fast stain of a bronchial alveolar lavage sample. A GEN-PROBE amplified direct test of the vitreous fluids was also positive. Ocular tuberculosis was confirmed. After treatment for tuberculosis and vitrectomies, his final best-corrected visual acuity improved to 20/30 in the right eye and 20/200 in the left eye. Ocular tuberculosis is rarely reported as the primary presentation of systemic tuberculosis in young patients. A negative Mantoux test may lead to misdiagnosis and delayed treatment. Doctors should become more familiar with the manifestations of systemic tuberculosis and use advanced diagnostic tools in cases of clinical suspicion.
PubMed: 29018695
DOI: 10.1016/j.tjo.2014.08.002 -
The Indian Journal of Chest Diseases &... 1997Out of 146 cases, 92 (64%) cases with active sarcoidosis showed granulomas in biopsy at 4-6 weeks after Mantoux test (MT). No granuloma was seen in anyone of the 162...
Out of 146 cases, 92 (64%) cases with active sarcoidosis showed granulomas in biopsy at 4-6 weeks after Mantoux test (MT). No granuloma was seen in anyone of the 162 sites injected with other allergens in 27 of MT site positive cases, serving as self-control. False positive biopsies were not seen. Another control group of 40 patients with other respiratory disorders like tuberculosis failed to produce any granulomatous response at the site of MT. Mantoux test site biopsy may prove a valuable diagnostic test in sarcoidosis in India.
Topics: Biopsy; Granuloma; Humans; Kveim Test; Sarcoidosis; Skin; Tuberculin Test
PubMed: 9100406
DOI: No ID Found -
PloS One 2018A group of Russian scientists has developed Diaskintest, which comprises Mycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2... (Comparative Study)
Comparative Study
Comparative sensitivity of the test with tuberculosis recombinant allergen, containing ESAT6-CFP10 protein, and Mantoux test with 2 TU PPD-L in newly diagnosed tuberculosis children and adolescents in Moscow.
BACKGROUND
A group of Russian scientists has developed Diaskintest, which comprises Mycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2 μg/0.1 ml).
STUDY PURPOSE
To evaluate the comparative sensitivity of TST with 2 TU PPD-L and a skin test with tuberculous recombinant allergen (Diaskintest) containing the ESAT6-CFP10 protein in children and adolescents with newly diagnosed active tuberculosis during mass screening in the primary medical service in Moscow.
MATERIALS AND METHODS
The trial was a comprehensive retrospective group study of children and adolescents diagnosed in Moscow with active tuberculosis in 2013-2016, aged 0 to 17 years inclusive.
RESULTS
From 441 patients selected for analysis 408 patients had both tests (TST with 2 TU PPD-L and Diaskintest) performed, in 193 patients both tests were given simultaneously, of them 162 patients were BCG-vaccinated. Comparative results of both tests in 408 patients with tuberculosis: at cut-off ≥ 5 mm, both tests has similar sensitivity: Diaskintest 98.3% (95% CI 97.0-99.6%), TST 98.0% (95% CI 96.7-99.4%), at cut-off ≥10 mm, the sensitivity decreases for both tests: Diaskintest 90.0% (95% CI 87.0-93.0%), TST 88.7% (95% CI 85.6-91.9%), but at cut-off ≥ 15 mm, the decrease in sensitivity is statistically significant: for Diaskintest 61.5% (95% CI 56.7-66.3%), and for TST 46.3% (95% CI 41.4-51.3%), p <0.0001. The results of simultaneous setting of tests on different hands in 193 people (including 162 BCG-vaccinated), do not differ from the results for 408 people. The correlation between the results of Diaskintest and TST was significant in all groups.
CONCLUSION
In children and adolescents with active tuberculosis, Diaskintest of 0.2 μg/ml and the Mantoux test with 2 TU PPD-L have high sensitivity (98%) at a cut-off of 5 mm; however, at cut-off ≥ 15 mm sensitivity is significantly reduced, and the decrease is more pronounced in the Mantoux test. The advantage of Diaskintest is that, unlike the Mantoux test, it has high specificity under the conditions of mass BCG vaccination. The test is simple to carry out, and can be used in mass screening.
Topics: Adolescent; Allergens; Antigens, Bacterial; Bacterial Proteins; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Moscow; Mycobacterium tuberculosis; Recombinant Proteins; Retrospective Studies; Sensitivity and Specificity; Tuberculin; Tuberculin Test; Tuberculosis
PubMed: 30576322
DOI: 10.1371/journal.pone.0208705 -
International Journal of Dermatology Nov 2011Diagnostic tests are critical to management when the clinical picture is unclear. We analyzed the records of patients in whom the initial diagnosis of cutaneous...
BACKGROUND
Diagnostic tests are critical to management when the clinical picture is unclear. We analyzed the records of patients in whom the initial diagnosis of cutaneous tuberculosis was doubtful to evaluate the utility of the Mantoux test in this setting.
MATERIALS AND METHODS
Of 375 patients with cutaneous tuberculosis seen in our department, the initial clinical diagnosis was doubtful in 90 patients. A Mantoux test was performed with 5 TU of purified protein derivative using standard techniques and read after two days. Patients also underwent skin biopsy and other laboratory tests and received treatment with antitubercular drugs. Patients who had case notes recording satisfactory improvement following antitubercular therapy were classified as having cutaneous tuberculosis; those with evidence of another diagnosis based on the laboratory tests and response to therapy were categorized as non-tuberculosis cases. Patients with inadequate evidence for a diagnosis of either cutaneous tuberculosis or another disorder were classified as unresolved diagnosis.
RESULTS
Readings were available in 79 patients: 39 were categorized as tuberculosis; 16 as non-tuberculosis; while a final diagnosis could not be reached in 24 cases. Readings ranged from 0 to 40 mm in the cases and from 0 to 30 mm in non-cases. The area under the receiver-operating characteristic curve was 0.66 (95% CI 0.55-0.81). Using a cut-off of 10 mm, the sensitivity and specificity of the tests were 58.97 and 62.50%, respectively.
CONCLUSION
The Mantoux test is of low accuracy in the diagnosis of doubtful cases of cutaneous tuberculosis.
Topics: Adolescent; Adult; Aged; Antitubercular Agents; Biopsy; Child; Child, Preschool; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Predictive Value of Tests; Pyrazinamide; ROC Curve; Rifampin; Tuberculin Test; Tuberculosis, Cutaneous; Young Adult
PubMed: 22004492
DOI: 10.1111/j.1365-4632.2011.04971.x -
Lancet (London, England) Mar 1981Two studies were performed to compare the disposable liquid tuberculin PPD 'Imotest' with the Mantoux test. While there was a tester effect in the first study indicating... (Clinical Trial)
Clinical Trial Comparative Study
Two studies were performed to compare the disposable liquid tuberculin PPD 'Imotest' with the Mantoux test. While there was a tester effect in the first study indicating the need for accurate application of the imotest, the results of the second study showed that the two tests were comparable in selecting truly positive and negative tuberculin reactors. Results were compared both by conventional methods and by a method new to tuberculin testing, the maximum likelihood technique. This method gives a more accurate estimate of false reaction rates. A significant difference was found between reading at 48 and 72 h for both tests. The acceptability and ease of reading of the imotest, with a tuberculin selectivity comparable to the Mantoux method, make it a suitable alternative tuberculin test, especially for screening large populations.
Topics: False Negative Reactions; False Positive Reactions; Humans; Methods; Punctures; Tuberculin; Tuberculin Test
PubMed: 6110916
DOI: 10.1016/s0140-6736(81)91974-7 -
IDCases 2019A 56-year-old woman who vaccinated as a child with the Bacillus Calmette-Guerin (BCG), now tests positive to the tuberculin skin test (TST) but test negative to the...
A 56-year-old woman who vaccinated as a child with the Bacillus Calmette-Guerin (BCG), now tests positive to the tuberculin skin test (TST) but test negative to the Quantiferon Gold assay. She has no history of tuberculosis contact and is asymptomatic. This dilemma now is, should be treated for tuberculosis or not, based only on the TST results? To prevent these falsepositive results with TST and avoid treatment with isoniazid (INH) it may be helpful to use interferon-gamma release assay (IGRA) instead, which unlike the TB skin test is not affected by prior BCG vaccination.
PubMed: 31720225
DOI: 10.1016/j.idcr.2019.e00658 -
BMC Public Health Oct 2019HIV-associated tuberculosis (TB) is a major cause of death among pregnant women in South Africa. Isoniazid prevention therapy (IPT) strategy was implemented in South...
BACKGROUND
HIV-associated tuberculosis (TB) is a major cause of death among pregnant women in South Africa. Isoniazid prevention therapy (IPT) strategy was implemented in South Africa concurrently with life-long antiretroviral therapy (ART) to reduce the TB-associated morbidity and mortality in individuals living with HIV. This study assessed the extent of the implementation of IPT and the performance of the Mantoux test by geographic settings of health facilities and residences of pregnant women living with HIV in the Eastern Cape, South Africa.
METHODS
We conducted a data analysis of 1709 pregnant women enrolled in the new electronic database of the prevention of mother-to-child transmission programme of the East London Prospective Cohort Study. Relevant data on place of residence and antenatal care, performance of the Mantoux test and subsequent initiation of IPT were obtained. Descriptive and inferential statistics were employed to analyse the geographical variations and accessibility to Mantoux test and IPT.
RESULTS
The analysis shows that Mantoux test was performed on 803 pregnant women (47%) with significant geographical variation. After controlling for relevant covariates, pregnant women who resided in rural areas (AOR:0.63; CI: 0.47-0.84) compared to those who resided in urban areas were significantly less likely to receive Mantoux test. The rate of uptake of IPT was 79% with significant geographic variations. In the unadjusted model, rural place of residence (UOR:0.68; CI: 0.49-0.96) was independently associated with lower likelihood of uptake of INH prophylaxis; however, the effect was not significant after controlling for important covariates.
CONCLUSIONS
The high uptake rate of isoniazid prevention therapy in pregnant women living with HIV at the study sites is commendable; however, concerted efforts are needed to address the inequality gaps in the roll-out of IPT. Poor performance of Mantoux test is a serious concern and requires the attention of TB programme managers and other relevant authorities.
Topics: Adolescent; Adult; Female; HIV Infections; Healthcare Disparities; Humans; Infectious Disease Transmission, Vertical; Isoniazid; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; South Africa; Tuberculin Test; Young Adult
PubMed: 31664978
DOI: 10.1186/s12889-019-7769-y -
Dermatology Reports Nov 2021Koebner phenomenon, also known as isomorphic response, is the appearance of active skin lesions in sites of epidermal injury. This manifestation is characteristic of...
Koebner phenomenon, also known as isomorphic response, is the appearance of active skin lesions in sites of epidermal injury. This manifestation is characteristic of different dermatological diseases, such as lichen planus, vitiligo and psoriasis. We present the case of a psoriatic patient who experienced Koebner phenomenon after Mantoux test, followed by eruption of generalized plaque psoriasis.
PubMed: 34880969
DOI: 10.4081/dr.2021.9019 -
Indian Journal of Public Health 1993Total 240 cases of 2-12 years age group who had contact of tuberculosis indirectly or directly and had chronic illness were screened for tuberculosis. Out of 240 cases,...
Total 240 cases of 2-12 years age group who had contact of tuberculosis indirectly or directly and had chronic illness were screened for tuberculosis. Out of 240 cases, 180 cases were diagnosed as tuberculosis. Special emphasis was given on Mantoux Test (M.T.), though the battery of tests were done to diagnose tuberculosis. Out of 180 cases of Tuberculosis, M.T. was Positive in 97 cases (40.41%) and repeat M.T. was done after 3 weeks and was converted to Positive in 20 cases (8.33%). Thus only M.T. help in diagnosis of Tuberculosis in almost 50% of the cases.
Topics: Child; Child, Preschool; Chronic Disease; Evaluation Studies as Topic; Female; Humans; Incidence; Male; Mass Screening; Nutritional Status; Radiography; Reproducibility of Results; Sensitivity and Specificity; Socioeconomic Factors; Tuberculin Test; Tuberculosis, Pulmonary
PubMed: 8138286
DOI: No ID Found -
International Journal of Pharmaceutics Dec 2006A formulation of a eutectic mixture of lidocaine-prilocaine (EMLA) changes basal skin perfusion. Its use for alleviating pain associated with the Mantoux test may modify... (Randomized Controlled Trial)
Randomized Controlled Trial
A formulation of a eutectic mixture of lidocaine-prilocaine (EMLA) changes basal skin perfusion. Its use for alleviating pain associated with the Mantoux test may modify the recruitment of sensitised lymphocytes and then the response to tuberculin test. Twenty-four healthy BCG-vaccinated volunteers (26.7+/-4.1 years) received on each forearm an intradermal injection of 10IU tuberculin, one of the forearms being randomly pre-treated for 1h with EMLA-patch 5%. Pain associated with the Mantoux test was evaluated using a visual analogue scale. The transversal diameter of the induration was read at 72h. Subjects with 6mm difference between diameters (i.e. twice the usual variation for a Mantoux test) were recorded. Results were compared using a paired t-test. When using lidocaine-prilocaine prior to the test, a three-fold decrease in pain was noted (p<0.0001). Reading of the test were not affected by the lidocaine-prilocaine application (p=0.26). Four subjects had 6mm or more difference between their two tests, two of them having an induration greater than 15mm with lidocaine-prilocaine. Lidocaine-prilocaine reduces significantly pain associated with the Mantoux test but does not normally affect the test reading. However, when the induration is more than 15mm, a control without lidocaine-prilocaine has to be considered.
Topics: Adult; Anesthetics, Local; BCG Vaccine; Drug Delivery Systems; Female; Forearm; Humans; Injections, Intradermal; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Pain; Prilocaine; Tuberculin; Tuberculin Test
PubMed: 16959450
DOI: 10.1016/j.ijpharm.2006.07.037