-
Journal of Preventive Medicine and... Mar 2017Tuberculosis (TB) is a contagious, infectious disease, due to Mycobacterium tuberculosis (MT) that has always been a permanent challenge over the course of human... (Review)
Review
Tuberculosis (TB) is a contagious, infectious disease, due to Mycobacterium tuberculosis (MT) that has always been a permanent challenge over the course of human history, because of its severe social implications. It has been hypothesized that the genus Mycobacterium originated more than 150 million years ago. In the Middle Ages, scrofula, a disease affecting cervical lymph nodes, was described as a new clinical form of TB. The illness was known in England and France as "king's evil", and it was widely believed that persons affected could heal after a royal touch. In 1720, for the first time, the infectious origin of TB was conjectured by the English physician Benjamin Marten, while the first successful remedy against TB was the introduction of the sanatorium cure. The famous scientist Robert Koch was able to isolate the tubercle bacillus and presented this extraordinary result to the society of Physiology in Berlin on 24 March 1882. In the decades following this discovery, the Pirquet and Mantoux tuberculin skin tests, Albert Calmette and Camille Guérin BCG vaccine, Selman Waksman streptomycin and other anti-tuberculous drugs were developed.
Topics: Antitubercular Agents; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Mycobacterium tuberculosis; Tuberculin Test; Tuberculosis
PubMed: 28515626
DOI: No ID Found -
The European Respiratory Journal Dec 2015Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical... (Review)
Review
Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone.
Topics: Antirheumatic Agents; Antitubercular Agents; Coinfection; Comorbidity; Disease Management; Drug Users; Emigrants and Immigrants; Evidence-Based Medicine; HIV Infections; Health Personnel; Ill-Housed Persons; Humans; Interferon-gamma Release Tests; Isoniazid; Kidney Failure, Chronic; Latent Tuberculosis; Mass Screening; Practice Guidelines as Topic; Prisoners; Public Health; Radiography, Thoracic; Renal Dialysis; Rifampin; Risk Assessment; Silicosis; Substance-Related Disorders; Transplant Recipients; Tuberculin Test; Tumor Necrosis Factor-alpha; World Health Organization
PubMed: 26405286
DOI: 10.1183/13993003.01245-2015 -
Indian Dermatology Online Journal Jan 2012The tuberculin skin test is one of the few investigations dating from the 19(th) century that are still widely used as an important test for diagnosing tuberculosis....
The tuberculin skin test is one of the few investigations dating from the 19(th) century that are still widely used as an important test for diagnosing tuberculosis. Though very commonly used by physicians worldwide its interpretation always remains difficult and controversial. Various factors like age, immunological status coexisting illness etc influence its outcome, so also its interpretation. Utmost care is required while interpreting the result and giving an opinion. This article has been written with the purpose of elucidating the performance and interpretation of the standard tuberculin test.
PubMed: 23130251
DOI: 10.4103/2229-5178.93479 -
Annals of Thoracic Medicine 2016Sternal mycobacterial infections are rare. Due to the rarity, its clinical characteristics, diagnoses, and regular management strategies are still scanty. A total of 76... (Review)
Review
Sternal mycobacterial infections are rare. Due to the rarity, its clinical characteristics, diagnoses, and regular management strategies are still scanty. A total of 76 articles on this topic were obtained by a comprehensive literature collection. The clinical features, diagnosis, management strategies and prognosis were carefully analyzed. There were totally 159 patients including 152 (95%) cases of tuberculosis (TB) and seven (5%) cases of non-TB sternal infections. Sternal mycobacterial infections can be categorized into three types: Primary, secondary, and postoperative, according to the pathogenesis; and categorized into isolated, peristernal, and multifocal, according to the extent of the lesions. Microbiological investigation is more sensitive than medical imaging and Mantoux tuberculin skin test in the diagnosis of sternal infections. Most patients show good responses to the standard four-drug regimen and a surgical intervention was necessary in 28.3% patients. The prognoses of the patients are good with a very low mortality. A delayed diagnosis of sternal mycobacterial infections may bring about recurrent sternal infections and sustained incurability. An early diagnosis and prompt antibiotic regimens may significantly improve the patients' outcomes.
PubMed: 27168857
DOI: 10.4103/1817-1737.180032 -
Postgraduate Medical Journal Aug 1970In 5529 new patients attending eye clinics 0·8% of patients were found to have endogenous uveitis. None had radiographic evidence of sarcoidosis. Of thirty-four who had...
In 5529 new patients attending eye clinics 0·8% of patients were found to have endogenous uveitis. None had radiographic evidence of sarcoidosis. Of thirty-four who had a Mantoux test 56% were negative. A Kveim test done on twenty-four of the cases revealed that 12·5% were positive, and in two of these histological evidence of sarcoidosis was found. Eighty-two patients with multisystem sarcoidosis were similarly investigated and in addition their lachrymal secretion was measured. Of these twelve (14·6%) had an ocular lesion, six having bilateral uveitis, two unilateral uveitis and four lachrymal gland enlargement. 58% of these cases were found to have reduced lachrymal secretion. In addition fifty-seven of these patients without ocular abnormality had their lachrymal secretion measured and 49% of these were found to have reduced lachrymal secretion.
Topics: Adolescent; Adult; Child; Female; Humans; Lacrimal Apparatus; Male; Middle Aged; Sarcoidosis; Uveitis
PubMed: 5481100
DOI: 10.1136/pgmj.46.538.501 -
Journal of Maxillofacial and Oral... Jun 2021This retrospective study evaluates the importance of Mantoux test and Erythrocyte Sedimentation Rate (ESR) levels in pediatric tuberculosis and also signifies the impact...
AIMS AND OBJECTIVE
This retrospective study evaluates the importance of Mantoux test and Erythrocyte Sedimentation Rate (ESR) levels in pediatric tuberculosis and also signifies the impact of this test in treatment planning and implementation in pediatric cleft lip and palate patients.
METHODOLOGY
Retrospective analyses of the records of 2010 pediatric cleft lip and palate patients below 5 years age were performed, and patients with elevated ESR subjected to Mantoux test were identified. The parameters included were age, sex, ESR levels, type of cleft, history of contact with TB & BCG vaccination, Mantoux conversion, chest X-ray findings, number of smear-positive pulmonary tuberculosis.
RESULTS
Out of 2010 patients with cleft lip and palate, 180 patients were subjected to Mantoux test due to high ESR levels. Among these, 54 (30%) patients found as Mantoux positive, in which 45 patients were identified as smear-positive pulmonary tuberculosis patients; as a result, surgery was deferred and they underwent antituberculous therapy. Most of the Mantoux-positive cases were found in patients with ESR range of 20-30 mm, i.e., 38 patients (71%), and common age group was 6 months-1 year. The most commonly involved cleft type was: unilateral cleft lip and palate having 36 patients (66.7%). The overall incidence of tuberculosis was 2%.
CONCLUSION
Although the correlation of Mantoux test with elevated ESR was not significant in our study, it could be of value as a screening tool along with the Mantoux test, which is sensitive but nonspecific in the diagnosis of active tuberculosis. Together, they could be a valuable screening tool in any community or hospital for diagnosis of the disease.
PubMed: 33927497
DOI: 10.1007/s12663-020-01348-5 -
Journal of Infection in Developing... Aug 2018Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors. (Observational Study)
Observational Study
INTRODUCTION
Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors.
METHODOLOGY
A prospective study enrolling 400 children (aged 2-12) suspected to have tuberculosis. All participants received Mantoux test with two different strengths (1 TU and 5 TU) of Purified Protein Derivative (PPD) on different forearms. The test was read by two readers after 48 ± 2 and 72 ± 2 hours. Primary outcome was difference in the size of induration when read by two readers (interobserver variability). Secondary outcomes were difference in the size of induration at different intervals, with different strengths of PPD and percentage positivity of Mantoux test in TB patients.
RESULTS
Statistically significant difference was seen in the size of induration when read by two different readers, with fair to moderate agreement when read at 48 and 72 hours (1 TU: p = 0.002, k = 0.52 and p = 0.1, k = 0.73 respectively, 5 TU: p = 0.001, k = 0.39 and p = 0.0009, k = 0.33 respectively). Tendency of under-reading occurred when size of induration was close to significant level (10-14 mm). Size of induration was similar when read at 48 or 72 hours (1 TU: p = 0.9, 5 TU: p = 1.0). Mantoux positivity rate in patients with TB was more with 5 TU as compared to 1 TU (61.2% vs. 16.3%).
CONCLUSIONS
There is significant interobserver variability with a tendency to under-read around the cutoff point. The use of 5 TU PPD at 48 hours by a trained physician can aid in early and more reliable diagnosis of TB.
Topics: BCG Vaccine; Child; Child, Preschool; Female; Humans; Male; Observer Variation; Prospective Studies; Tuberculin Test; Tuberculosis; Tuberculosis, Meningeal; Tuberculosis, Pulmonary
PubMed: 31958324
DOI: 10.3855/jidc.9601 -
Journal of Family Medicine and Primary... Feb 2022Tuberculosis (TB) is one of the main causes of mortality among infectious diseases. The prevalence of tuberculosis is very high in developing countries such as India....
BACKGROUND
Tuberculosis (TB) is one of the main causes of mortality among infectious diseases. The prevalence of tuberculosis is very high in developing countries such as India. Mantoux test is frequently used for the diagnosis of latent or active tuberculosis despite low sensitivity and specificity. However, the Mantoux test is a crucial test in a resource-less setup for the diagnosis of TB. Therefore, the main purpose of this study was to find the dropout rate and dropout reasons in Mantoux testing.
METHODOLOGY
All suspected TB patients attending out-patient department and further tested for Mantoux test.
RESULTS
Of the total 789 Mantoux tests, 459 (58%) were negative, 195 (25%) were positive, and 135 (17%) were dropouts. One of the main reasons for dropout was patients did not give importance to the Mantoux test.
CONCLUSION
Dropout rate in Mantoux testing can be reduced by patient counseling regarding TB and Mantoux test by the doctor.
PubMed: 35360823
DOI: 10.4103/jfmpc.jfmpc_1355_21