Talk:Mantoux test

False positive result

I removed "False result can be confirmed by chest x-ray" as a positive ppd with a negative xray is considered latent TB and the person is treating with INH.98.119.99.84 (talk) 02:27, 2 September 2009 (UTC)

Mantoux Test

Is an individual who tests positively on the Mantoux Test - 15 MM and who needs to pass the TB Test National disqualified when emloyment opportunities call for a TB Test?

The occupational health department may require a chest X-ray and sputum samples if possible. JFW | T@lk 16:44, 22 September 2005 (UTC)

The Mantoux test only indicates that a person has or has had the infection, not that he or she is infectious (which is sometimes referred to as being "active" or having "active TB" or "infectious TB"). The exam forms that I have seen all request certification that the patient is not infectious... this usually requires a chest x-ray and a history. Although I have never had a request for a sputum test, I suppose that it might be requested in certain circumstances (i.e.: if the prospective employee will be dealing with very immune-suppressed patients).

Annual CXR in lieu of Mantoux

As an aside, an annual chest x-ray used to be requested in lieu of a PPD for anyone who had a history of a positive TB test. That is no longer the case, as a repeat x-ray is only indicated if a patient is symptomatic (persistent cough, night sweats/fevers, or weight loss). Carl 00:43, 1 December 2005 (UTC)

That is only true in the US and not elsewhere. The UK recommendations still allow for regular CXR as an alternative to the mantoux test.--Gak 15:42, 13 September 2006 (UTC)

Merge with tuberculin

I have removed the request for discussion about a merge with Tuberculin, as Tuberculin has been changed, making such a merge no longer needed. Carl 00:47, 1 December 2005 (UTC)

*The merge request was put back. Since there already seems to be a talk consensus to keep two separate article,  I removed the
merge proposal and added a disambiguate link so that people looking for the TB test will be directed to Mantoux test.
 I know there is a see-also, but this seemed like a compromise to the merge proposal.
Thatcher131 14:40, 17 February 2006 (UTC)

Reliability of Mantoux test

One issue that I was curious about that was not mentioned was the reliability of the test. I believe that this is a screening type test (i.e. a cheap one with a high degree of false positives and a low degree of false negatives), but was curious to know if any contributors hae the actual rates available. --199.158.144.234 22:53, 11 July 2006 (UTC)

The Mantoux test is a screening test for latent TB and is of no use in diagnosing active TB. The trouble is that there is no gold standard test for diagnosing latent TB against which the Mantoux can be compared, so interpretation varies from country to country. Someone who is "diagnosed" with latent TB in the US may very well be said to be negative in the UK.--Gak 15:42, 13 September 2006 (UTC)

From a US/Canada perspective, or the rest of the world too, is there any data in the current era that quantifies what 9 months INH monotherapy for isolated PPD positivity meaningfully achieves? Has there been any recent reconsideration of the benefits against any risks, including cost of medication? Also, how often do health care workers (HCW) positive PPD (negative symptoms, exam, Xray, and QuantiFERON_TB Gold)?--FeatherPluma (talk) 18:59, 18 November 2010 (UTC)

Tuberculin skin testing

Link removed to "Tuberculin skin testing" because that article has been deleted and merged with other articles.

Section headings

I have added section headings because the discussion pages is getting a bit big.--Gak 15:42, 13 September 2006 (UTC)

Move to Tuberculin skin test

This article talks about much more than just the Mantoux test. Why not move to tuberculin skin test and redirect Mantoux to that link?--Gak 19:48, 17 September 2006 (UTC)

Mantoux vs. Pirquet

The introduction to this article presents Pirquet testing as a synonym to Mantoux testing. In Norway an older testing procedure known here as the Pirquet test was in use until recently (2004 according to no:Tuberkulintest). It involved making two small scratches to the inside of the lower arm and dripping tuberculin solution onto them, somewhat like allergy scratch testing. Is this a Norwegian-only terminology? Otherwise the wording should be changed to reflect the difference (although the skin response and interpretation of the two tests are similar). --shingra (talk) 09:54, 21 May 2008 (UTC)

I'm in Norway. No, Pirquet is NOT Norwegian-only terminology, it is European though (I might add that the Norwegian popular term for it, especially amongst school children getting tested at school by the school nurse, is "The Cat Scratch" though (norw. "katteklor") - since that is how it both looks and feels when it is done. It was never considered a scary occurance for the kids to have their Cat Scratch done at school, clearly different from testing involving a syringe which many finds scary and painful). The term Pirquet, as usual, I might add, comes from the man developing the method, Pediatrician Clemens Peter Freiherr von Pirquet (Born May 12th, 1874 in Vienna, Austria. Wikipedia article is titled Clemens von Pirquet), Died February 28th, 1929 - Freiherr is a title meaning "baron", not a name). He was mostly known for his contributions within the fields of Bacterology and Immunology. Together with Bela Schick, he also established the term Allergy (from gr "allos" meaning "others" and "ergon" meaning "reaction") to describe the hypersensitivity reaction he observed in 1906 when patients who earlier had received injections of horse serum or the Smallpox vaccine had a faster and more severe reactions when they had a secundary injection. Shortly after the observation with Smallpox, Pirquet understood that Tuberculin, which Robert Koch had isolated from the bacteria causing Tuberculosis in 1890, also could lead to such a reaction, and he developed the Pirquet test. Charles Mantoux further developed Pirquets ideas and the Mantoux test, where Tuberculin is injected intracutaneously, and this became a diagnostic test for Tuberculosis in 1907. The Pirquet test is done differently, something as simple as a dip pen nib is used to scratch the skin in 2 or 3 around 1/8" long scratches placed approx. an inch apart across the forearm before a drop of Tuberculin (OT - Old Tuberculin) is dripped onto the skin and left to absorb for a little while. 2-3 days later, the skin reaction is read (the redness and swelling is measured. With no reaction, a negative result, it is noted as a "0/0" result). Many in the medical community in Norway would have preferred to still use the Pirquet test, as they consider it more accurate than the Mantoux test(and giving less false positives). The change to using the Mantoux test instead, was mostly done since the different testing methods made it difficult to compare studies/research from Norway and other countries using the Mantoux test. I am not sure which substance was injected in the original Mantoux test back in 1907 (OT or PPD), but in today's Mantoux test they inject Purified Protein Derivative (PPD), while the Pirquet test uses Old Tuberculin (OT), so that is also a difference between the Pirquet and Mantoux test methods.

I can add that Clemens von Pirquet in 1909 refused a position at the Institut Pasteur in Paris in order to instead become a Professor at Johns Hopkins Hospital in the US. However, in 1910 he returned to Europe, where he got a position in Breslau (Now Wrocław) in Poland and later in Vienna, Austria. His life ended sadly. On February 29th, Clemens von Pirquet and his wife committed suicide. (my source for the information about Clemens von Pirquet is an article on the Norwegian Wikipedia).

Anyway, this article should no doubt be corrected where Pirquet is mentioned as a synonym to Mantoux, as these testing methods are clearly different, not only done in a different manner (scratching vs. injection), but also using different substances (OT vs. PPD).

Peapeam (talk) 15:59, 27 January 2011 (UTC)