What to do if Mantoux is itchy and swollen in a child or an adult.
The tuberculin test was developed in its classic version in 1890 by the German microbiologist R. Koch.
And later, in 1912, the French physician C. Mantoux proposed the use of Koch's bacilli lymph for diagnostic purposes.
The Mantoux test (vaccination) or tuberculin test is one of the most important tests for diagnosing tuberculosis - dead pathogens are injected subcutaneously with a syringe into the inside of the arm to find out whether a person is sick with this disease, which is quite common in the world.
It is known that each person has his own individual characteristics of the body, which react in their own way to drug intervention.
Immunological status, age, and concomitant chronic diseases can affect the results of the analysis. Therefore, you need to be especially careful when interpreting the result.
Mantoux vaccination allows you to quickly and reliably detect tuberculosis infection in the diagnosis of pulmonary diseases.
The Mantoux test for epidemiological diseases shows the spread of tuberculosis infection in a certain region.
It is impossible to become infected with tuberculosis using the medical drug tuberculin through a test.
- How is the Mantoux reaction analyzed?
- Reaction to test administration, rules, timing, contraindications
- Why does the Mantoux vaccine itch and itch?
- Video on the topic
Rules for the procedure
Mantu is carried out without fail on average once a year - among preschoolers and schoolchildren.
At the age of sixteen, some high school students take their certificate and go to get a profession. Fluorography is becoming the main method of diagnosis and control. It happens that it starts to itch in this area. It’s impossible to resist, you want to relieve the itching by running your fingertips, nails or cloth over this area at least several times. This reaction is by and large natural, because a healing wound often itches. Even if the protective layer of the ichor is accidentally damaged, nothing bad will happen. Normal skin will soon appear.
The regeneration process proceeds normally; if the abrasion begins to itch, the nerve endings are restored. In the case of mantu, the same thing happens, but not quite. The injection site is a small area, slightly larger than a skin pore in area. Sometimes a person does not notice such damage at all.
A child’s mantu often itches worse than abrasions or scratches. This is a normal reaction to tuberculin. But allergic reactions are also possible. We must pay close attention to the child’s complaints. You can expect not only scabies, but also burning and fever. In three days the result will be known.
It happens that it is better to contact a therapist or physiatrist ahead of schedule. He will tell you what to do.
Sometimes the mantu itches only because the fabric of the clothing sleeve gets in the way and irritates the skin. I just need to change my clothes and everything will be fine
It is best to distract the child with some activity, explain the importance of the procedure, turn on a favorite cartoon, ask him to draw something.
Since the procedure is most often carried out in one school parallel or in several, with friends nearby, the children do not pay attention to the injection.
They release the accumulated tension at home. Parents need to put themselves in the child’s place, tear him out of the captivity of negative emotions and experiences.
Every parent probably knows how to do this. You can indulge one day or all three, but do not comb the papule.
How is the Mantoux reaction analyzed?
At the injection site, a swelling forms, popularly called a “button,” which either resolves or increases in size over time.
48-72 hours after administration of the drug, the doctor or specially trained nurse measures the size of the papule with a special ruler, which takes on a rounded appearance and increases in size, and then compares the sizes with established standards:
- 0-1 mm – negative reaction. A person can be calm that he is healthy;
- 2-4 mm is a questionable reaction. In this case, the Mantoux test should be repeated;
- 5 mm – positive reaction. There is a high probability of the presence of the disease, in which case additional examination is required to confirm the diagnosis;
- 17 mm is a sign of disease.
Only the papule itself is measured with a ruler, and not the reddened area of skin on the arm.
A particularly pronounced positive reaction is observed when the diameter of the infiltrate is more than seventeen millimeters with suppuration and necrosis of the skin, which immediately gives grounds to refer the patient to a phthisiatrician.
With a weakened immune system, there is a high chance of contracting tuberculosis, and also directly leads to redness of the papule.
But a red, swollen button does not always prove that the child is sick.
The large size of the seal and reddened skin are the reasons for repeated administration of tuberculin throughout the year.
In this case, you should inform the doctor that the baby has already been given Mantoux.
Automatically repeated tests will differ from normal deviations.
The diameter of a papule is considered positive when it reaches five millimeters or more.
In this case, special monitoring of the child is required for several years.
If the button tends to increase in size in subsequent years, then the phthisiatrician should prescribe treatment.
A questionable reaction is a bulge size of up to 4 mm with redness of the skin around the lump at the injection site.
Then the sample is ordered to be repeated in order to have evidence of the absence of the disease with a small number of bacteria.
The negative reaction reaches one mm, completely clean, not swollen and without reddened skin at the site of vaccination.
Parents are calm, this means that their child is completely healthy.
But redness of the skin near the test, an enlarged “button”, sometimes even suppuration at the vaccination site cause fear and anxiety for all mothers without exception.
But most of all, parents should be wary of the moments where previous tests were doubtful, and then immediately became sharply negative.
This may mean that the patient is more susceptible to tuberculosis, although the disease itself has not yet manifested itself.
But, one way or another, you should not be afraid of vaccinations and refuse them because of reddened skin.
After all, the Mantoux test will help to avoid contracting the disease, will show whether a person is at risk and how susceptible his body is to Koch bacilli.
This is especially important for those who have constant contact with sick people. This test is done once every twelve months, from the age of one to fourteen years.
This test is done once every twelve months, from the age of one to fourteen years.
If there are sick people in the family, then the Mantoux test is done until the age of eighteen.
Members of the family in which a person with tuberculosis lives are tested more often - 3-4 times a year.
The hands for each injection are constantly changed. Mantoux is never injected into one hand twice in a row.
But even a red, swollen button does not prove that the child has tuberculosis.
Especially if he is given a second injection within a year.
Adults should inform the doctor that the baby has already been given Mantoux.
Automatically repeated tests will differ from normal deviations.
In even-numbered years, tuberculin is injected into the right inner side of the arm, and in odd-numbered calendar years - into the left arm.
If there is no mandatory BCG vaccination, then the Mantoux test is checked twice a year.
How is the Mantoux test done?
Children are tested annually, from 12 months until the child reaches 14 years of age; schoolchildren and preschoolers are required to take the test. If the BCG vaccination has not been completed, then the test is carried out twice a year, and if the baby comes into contact with tuberculosis patients, then the test becomes more frequent up to four times. The injection is usually given in the forearm closer to the wrist. If there is a need to re-introduce tuberculin, it is placed on the opposite hand.
Commonly used for introduction:
- Left forearm in odd years.
- Right when it's even.
For right-handers and left-handers, the injection is given in the same area without any changes. The drug is injected under the skin, causing the epidermis to swell and settle within a few hours.
During the day, the body begins to react and slight redness appears, and within three days the injection area has a clearly defined round swelling called a “papule”. An important aspect is that the test is never done together with other vaccinations, and the necessary injections are given to children several months in advance; if “live” vaccinations are given, it is better to do so 2-3 months in advance. The doctor warns parents to ensure that the child does not scratch Mantu, otherwise the injection will have to be repeated due to improper distribution of the drug under the skin. But what are the reactions and what is their cause? What can cause swelling and itching, as well as terrible swelling, as in the photo? When should you use Suprastin? And what happens if you wet the area where tuberculin is injected?
Results and types of reactions in children and adults
The injection analysis is carried out using the same parameters in adult and minor patients, the reaction is considered:
Negative
If the spot does not bleed and there is no open ulcer or large swelling. The spot itself is close to flat and stands out from the healthy epidermis with slight redness, has a round shape and no more than 4 millimeters in diameter. If one of the parameters does not match, the analysis is considered doubtful and a survey is conducted to determine the need for further diagnosis.
Doubtful
A small but obvious swelling and a visible correlation with healthy skin, as well as an increase in the diameter of the spot ranging from 4 to 12 millimeters are considered questionable reactions. If the form of redness is violated, it is customary to give a second injection on the other hand and monitor the child’s behavior more carefully so that he does not wet it or scratch it. A questionable result means that the body’s reaction is not as obvious as with a positive one, but still raises concerns about tuberculosis at the obvious stage or stage of infection. A survey is conducted to find out the reasons for the distortion of the tests and, if necessary, further diagnostics are prescribed in order to make a clear diagnosis whether it is worth re-vaccinating.
Positive
Is the spot noticeably bleeding or has it developed into an open ulcer, has the swelling risen significantly above the epidermis, and is its diameter over 14 millimeters? The analysis is considered definitely positive and a full diagnosis is prescribed to determine the presence of Koch's bacillus in the body. The child undergoes a culture and a general blood test with urine. And if, as a result, doctors find nothing, Mantoux is considered a false positive.
False positive
When a positive or questionable reaction is brought to culture and collection of general tests, as a result of which the absence of the disease or symptoms not associated with it are established, a false positive reaction is determined. According to statistics, 54 percent of all positive results turn out to be false positive, so there is no need to worry if your baby’s injection area begins to itch and the swelling increases in size. Panicking parents will only make the situation worse, causing additional stress for the child and creating discomfort for themselves.
Where is the test done and in what cases should you sound the alarm?
As already mentioned, the test is done in the forearm area, closer to the wrist. The hand is selected depending on whether the year is even or odd, but the test on the hand is nothing more than a convention. In fact, the vaccine can be placed anywhere; this area was chosen because it is the least active in use and rarely comes into contact with other objects or is used during active activities. But if it is not dangerous for a child to comb Manta, when should you turn to a phthisiatrician for help?
If:
- The child has been in contact with tuberculosis patients or lives in the same building with them.
- The swollen area has developed into an open ulcer and severe swelling is noticeable. Or it continues to swell a week after the readings were taken.
- An increase in temperature, difficulty breathing and a persistent cough were noticed.
If you have such symptoms, you should immediately contact the nearest clinic and undergo a full diagnosis. The sooner you do this, the better.
Based on the test results, you will be prescribed a course of antibiotics and further treatment will be prescribed.
When Mantoux itches
07.08. Mantoux reaction 1,
How is the Mantoux reaction analyzed?
- 0-1 mm – negative reaction. A person can be calm that he is healthy;
- 2-4 mm is a questionable reaction. In this case, the Mantoux test should be repeated;
- 5 mm – positive reaction. There is a high probability of the presence of the disease, in which case additional examination is required to confirm the diagnosis;
- 17 mm is a sign of disease.
The diameter of a papule is considered positive when it reaches five millimeters or more. In this case, special monitoring of the child is required for several years. If the button tends to increase in size in subsequent years, then the phthisiatrician should prescribe treatment.
A questionable reaction is a bulge size of up to 4 mm with redness of the skin around the lump at the injection site. Then the sample is ordered to be repeated in order to have evidence of the absence of the disease with a small number of bacteria.
But most of all, parents should be wary of the moments where previous tests were doubtful, and then immediately became sharply negative. This may mean that the patient is more susceptible to tuberculosis, although the disease itself has not yet manifested itself.
Reaction to test administration, rules, timing, contraindications
Until the age of five, children may have a positive reaction to the Mantoux vaccination with large swelling, redness, itching due to the BCG vaccination performed in the maternity hospital and immunity to Koch bacilli (by the age of seven, these symptoms disappear in children). Leukocytes actively react to the administered medication and receive an allergic reaction with redness at the injection site. Therefore, phthisiatricians often ask for additional tests to refute a positive Mantoux test in children. If a positive reaction to the vaccine is detected, treatment should be started immediately. A person can be registered in the zero group of anti-tuberculosis surveillance for tuberculosis infection if the tests are not too bad, and with critical tests they will offer medical examination in the hospital.
Why does the Mantoux vaccine itch and itch?
After performing an immunological test - the Mantoux test, a number of certain rules must be followed:
All these above points should be followed to avoid misdiagnosis. A correct diagnosis will help to decide why people experience redness of the skin, bloating and scabies. The itching caused by the test may cause health problems. First, you should rule out an allergic reaction or severe sensitivity to the drug “tuberculin”. Only a TB doctor can make a correct diagnosis after a medical examination. Many people have Koch bacilli in their bodies in small quantities and in a dormant state. After the test, this automatically causes redness and swelling of the papule at the first stage, and then suppuration may occur at the injection site. The degree of individual disease and the number of Koch bacilli in the body will be shown by microbiological culture of sputum taken for analysis.
Will it affect the reaction if a child scratches Mantu?
If a child scratches the Mantu, this may cause an incorrect evaluation of the sample. Such concerns are explained by the fact that during the test, tuberculin is injected into the skin of the forearm in a strictly defined amount - 1 dose (0.1 ml of a standardized solution). After the injection, a whitish elevation is formed - a papule; if you rub and comb it, the diameter usually increases.
When evaluating the test, measurements are taken after 48-72 hours, for which every millimeter is very important. If the diameter is higher than normal (from 5 to 17 mm) or has increased by 6 mm or more compared to last year, then the child needs to be examined by a phthisiatrician.
Therefore, if scratching of a papule is detected, it is necessary to notify the doctor or nurse who will conduct a control examination of Mantoux. There is no danger to the child's health when scratching the sample, unless infection is introduced.
Why does it itch
The papule itches after the injection of tuberculin, as the allergen is injected intradermally. It is specific for tuberculosis infection, but a local allergic (nonspecific) reaction is also quite possible. It occurs especially often in patients with a tendency to allergies. Signs of hypersensitivity to tuberculin (in addition to itching) include:
- swelling of the skin around the injection;
- soreness at the skin test site;
- rashes (single elements).
The test is contraindicated for children with allergic diseases in the acute stage (for example, urticaria, seasonal runny nose, asthma). For diathesis or food allergies, atopic dermatitis in the subsiding stage, the pediatrician usually prescribes antihistamines (Claritin, Cetrin) 3 days before Mantoux.
We recommend reading about whether Mantu is worth doing after an illness. From the article you will learn why you can’t do Mantoux after an illness, whether it can be done a week after chickenpox, measles, where to get a medical outlet from Mantoux after an illness.
And here is more information about how to reasonably draw up a Mantoux waiver.
What happens if you scratch, is it possible to do this?
You should not scratch the papule after the Mantoux test, as this will contribute to the spread of tuberculin beyond the injection. This manifests itself as an increase in the size of the elevation and the red spot. As a result, when evaluating a skin test, the doctor will record a larger diameter of the papule than it actually is. This reaction is called a false positive.
In doubtful cases, the child will undergo additional diagnostics - a repeat test after 0.5-1 month (usually Mantoux is replaced with Diaskintest) or a consultation with a phthisiatrician. The doctor may limit himself to examining and x-raying the parents if there are no symptoms of tuberculosis infection and no known contact with the sick person.
If there are suspicious signs (weakness, sweating, cough, weight loss, fever), the following must be prescribed:
- chest x-ray;
- blood tests: PCR (polymerase chain reaction for Mycobacterium tuberculosis), T-spot, quantiferon test.
What happens if you comb Mantu
After vaccination, parents should keep an eye on the child and explain to him that he needs to be patient and not scratch Mantu. Otherwise, the procedure will have to be repeated and additional examination will be required. What happens if the adults didn’t pay attention and the baby managed to scratch the injection site? Such actions increase blood circulation, the red spot increases and inflammation appears.
Increased swelling and redness leads to distorted test results. If a child had dirty hands, he could introduce an infection into the wound, and this could lead to suppuration.
Further actions must be coordinated with the doctor, who, after the examination, will prescribe a re-examination or decide that you can wait until next year.
What is mantu
Mantoux is an injection of tuberculin under the skin. The solution contains specific proteins and other chemicals obtained from dead cells of the tuberculosis bacillus.
The injection is given in the area between the hand and elbow or in the forearm. Within 72 hours, the immune system will send antibodies to the injection site. As a result, inflammation should appear on the skin, the so-called mantoux button.
A positive reaction is considered to be the appearance of redness with a diameter of more than 6 mm. If the diameter is 2-5 mm, the mantoux result is questionable. If the diameter is 0-1 mm, then the result is negative.
We are not talking about illness even if an infectious agent is detected in the body. Scientists suggest that almost every third person on the planet today has a Koch bacillus in their body. But the immune system prevents you from getting sick. And in the case when the BCG or BCG-M vaccination was not done, mantu still needs to be done.
The introduction of specific substances, aggressive, in fact, helps stimulate the formation of a response. Mantoux vaccination is an unreliable insurance and ineffective from a scientific point of view. It has an indirect relation to immunization.
For what reasons does itching occur?
Can there be itching after Mantoux? This question often arises among parents of children.
Redness and mild itching a short time after any vaccination are quite normal. Within one to two days the symptoms subside and then disappear completely. If the unpleasant burning, itching, and redness continue, this means that there are some health problems.
Mantu can itch for several reasons:
A sharp reaction of the body to the administration of the drug. The area where the injection was given may become swollen and very itchy. This is quite possible, and the itching in this case goes away quickly. Allergic reaction to the drug tuberculin. In this case, the Mantoux test can no longer be performed. It will be necessary to use other methods to determine the disease. A recent infectious disease. If a person has just recently been ill, and then the Mantoux test was done, then the injection site may well itch. This reaction is considered false. The papule was infected
As a result of careless behavior, the place became infected. This is the most common cause of itching in children. Water got into the injection site
Contact with water will certainly lead to an adult or child experiencing severe itching at the injection site.
You also need to know the following:
- After performing the Mantoux test, you should try not to scratch the injection site.
- Do not wet the button with water for three days.
- There is no need to treat the area where the vaccination was done with any medications, including iodine or brilliant green.
- Do not cover the injection site with a band-aid, as this may cause skin irritation.
- For several days you need to refrain from eating foods that provoke an allergic reaction (chocolate, citrus fruits).
- Clothing should not rub or injure the injection site.
- You cannot do the Mantoux test together with any other vaccinations. They should be carried out either in advance (a month before the intended injection) or after Mantoux.
These rules must be conveyed to the child in an accessible form. They will help to avoid the button being injured and its size and shape changing. Consequently, the doctor may misdiagnose.
It is quite natural that a person has a strong desire to scratch the papule formed after the injection. If an adult does this to a child very carefully and with gentle movements, then there will be no negative consequences.
But if this is done carelessly and as a result of scratching the papule becomes larger and begins to itch, it is necessary to take action
To do this you need:
- give an antihistamine, for example, Suprastin;
- It is advisable for the child to wear long sleeves if environmental conditions allow. He will see less of the injection site, which means the desire to scratch it will also be reduced.
If there is itching, but the size of the papule is fine, there is no need to panic. If it starts to hurt, becomes swollen, or swelling appears at the injection site, you should immediately contact a specialist. In this case, you cannot waste time. This attitude can cause complications.
When the injection site begins to itch, you should pay attention to some points, namely:
- how much time has passed since the start of the test;
- whether the papule has increased;
- whether there was a violation of the button care rules.
You need to calmly tell the child that the injection site should not be scratched or injured.
Is this normal or not?
In order to answer this question, it is necessary to understand the features of the procedure. During this procedure, tuberculin is injected under the skin in the wrist area. The body exhibits a local reaction to the administration of the drug, manifested in swelling of the surface layer of the skin and its redness. Soon after this, such a pronounced reaction becomes less noticeable, the affected area decreases and a papule is formed, based on the size of which one can conclude whether the child is infected with tuberculosis.
If the child has been vaccinated, then in a normal situation the papule will be small in size, but still be pronounced. Too large and inflamed papules indicate that the child is infected with tuberculosis. Completely absent or very small papules indicate that the child has not been vaccinated or is not sensitive to the BCG vaccine, which is also bad.
The mere presence or absence of itching at the test site does not indicate one option or another . Both in the absence of infection and in its presence, itching may or may not appear or be intermittent. But if a child scratches a manta ray, the reaction zone may seem enlarged, and then during control measurements the doctor may regard the reaction as positive, although in fact the child is not infected with tuberculosis.
If Mantoux itches, is it tuberculosis?
It's all about the impulses that the body sends to the central nervous system in response to irritation of the epidermis
An irritant gets into the skin, the body doesn’t like it, so it pays attention to it and requires some action - for example, scratching the sore spot. But under no circumstances should wounds be scratched - this risks secondary infection and inflammation.
In addition, assessing the test results will be significantly difficult due to improper distribution of the drug under the skin, hyperemia, irritation, and possibly even bruising at the site of the injection mark.
How to help a child if Mantoux itches very much?
- put the child on clothes with long but loose sleeves;
- make sure that the room is not too hot - sweat will make the button itch even more;
- do not wet Mantu;
- distract yourself with an interesting activity or walk.
The button can be lubricated with antihistamines, disinfectants, anti-inflammatory ointments and lotions only after examination by a doctor and evaluation of the results. Then you can take systemic antiallergic drugs. Sometimes mothers and fathers themselves provoke severe itching in the baby. The more the child is told that the button should not be touched, the more they frighten him, the more attention he pays to the problem area and the more he wants to touch and scratch it. Therefore, you need to monitor your baby, but at the same time you should not remind him about the Mantoux test again.
How to prevent a child from scratching Mantu?
Parents fall into despair when the baby again and again feels for a button on the arm and begins to comb it until it bleeds. Unfortunately, nothing can be done here, since the use of alcohol and antihistamines is strictly prohibited. All parents can do is distract the child with walks and interesting games. You cannot seal the wound or smear it with anything.
What does the phthisiatrician recommend?
With Mantu combed before the doctor assessed the results, the situation is more complicated. Obviously, the injection site will be swollen and red. And, most likely, the doctor will advise you to redo the sample and undergo several additional examinations, for example, Diaskintest or PCR diagnostics. You should not refuse additional examinations - perhaps severe itching, which the child could not tolerate, is a manifestation of tuberculosis. It is better to pass all the necessary tests and make sure that everything is in order, or start treatment as early as possible.
If you ignore the rules
Why should you not scratch the tuberculin injection site?
It's simple. The result may not be reliable if done this way.
Blood circulation will be more intense and specific substances injected under the skin will spread to neighboring tissues. The papule may turn into a huge red spot or, conversely, disappear. But most likely, if you comb a manta ray, severe inflammation will appear.
You cannot scratch this area, even if you really want to. As with a mosquito bite, scratching it once is dangerous - you'll want to do it again. It’s better to sit down and think about why the manta ray actually itches.
If a child scratched an injection and the parents did not pay attention in time, what consequences should be expected and what should be done?
The papule is probably swollen and there is a bruise. But it is not recommended to treat it with alcohol, iodine, brilliant green, hydrogen peroxide or any ointments.
It is advisable to ask the child not to touch the itchy hand for half an hour. He will probably feel significant relief after this.
Bandaging or covering the papule with a band-aid is also not recommended. So you should still come to an agreement with the baby. Children most often have a negative attitude towards injections and will probably not like the prospect of having to repeat the procedure. And this is exactly what the doctor will have to do if he cannot obtain the necessary information.
When tuberculin is administered, it is impossible to get tuberculosis. You will have to wait a while until the effects of the first injection wear off, then inject again.
Will the doctor believe that the child scratched the manta ray?
If the baby actually combed the manta ray, it will be noticeable. Although there are exceptions. It is worth warning your doctor. A hypertrophied positive reaction to the test is similar to a combed area, of course. The allergy is characterized by an increase in the area of redness.
If the wound is swollen or there is suppuration, a more detailed examination may be needed. The child probably had dirty hands.
And yet this will need to be refuted or confirmed. If the manta reaction cannot be distinguished upon examination from scratching, additional research will help to understand the situation.
Causes of the rash
There are several reasons for the appearance of a rash on the body after Mantoux vaccination. Regardless of whether it is a child or an adult, allergies appear in the same cases. This:
- Intolerance to many medications. The immune system of such a patient is hostile to any chemical invasion, including the contents of the vaccine.
- Individual intolerance to tuberculin. With such a pathology, the Mantoux test should be abandoned forever, replacing it with another.
- Allergy to phenol. This is a substance that is part of tuberculin.
- Weakened immunity. In this case, even someone who has never experienced anything like this before can develop an allergy.
- The test was taken during a period of exacerbation of allergies. To avoid this, the skin must be clean during the procedure.
Whatever the cause of the rash, it is necessary to find out. It is quite possible that the injection has nothing to do with it, and this is a food allergy that coincided in time. Therefore, before going to the doctor, it is better not to give the victim any medications, so as not to blur the clinical picture. In severe cases, you need to call an ambulance.
Vaccination against tuberculosis
The vaccine against tuberculosis is called BCG or BCG-M. It is done in infancy and at the age of six. Few people remember how it was. But everyone remembers about mantu.
I think no. This is an unusual procedure, memorable. True, sometimes all that remains is a memory of how much the papule itches. Itching can be called a common, classic reaction. However, you cannot scratch the manta ray.
After the BCG vaccination, itching does not appear. When carrying out immunization, a vaccine is used, which consists of weakened bovine tuberculosis bacilli. As a result, the body develops an appropriate immune response - antibodies are synthesized. They completely suppress weakened microorganisms from the vaccine. Those are removed from the body. But the reaction doesn't end there.
Antibodies continue to be synthesized for several more years. The body and immune system are now informed that the environment is not a safe place, there is a threat - tuberculosis.
Usually, upon contact with the carrier, objects on which the stick is contained, very few harmful microorganisms enter the body of a healthy person. But they soon begin to multiply. The human body is a favorable environment for them. For this reason, the population is growing rapidly.
A sustained immune response is needed so that when infected, the body can destroy bacteria before they multiply. Alas, the tuberculosis bacillus is very aggressive. You can get sick even if you are vaccinated, but it will be easier to recover.
Why does Mantoux itch?
A solution of tuberculin, a drug that is an extract from killed tuberculosis bacilli, is injected under the skin. For the human body, this substance is an allergen. An allergic reaction occurs, the upper layer of skin swells. The brain sends a signal to nerve cells that forces them to respond to a foreign stimulus. The nerve tissue at the injection site becomes irritated, and as a result, the skin begins to itch.
In addition to the intense itching of the Mantoux wound, the child may experience burning pain after the procedure, and sometimes the body temperature rises.
Causes of itching
For most patients, the injection area itches and hurts. But, if the pain lasts only a few hours, then intense itching lasts up to 3-4 days. The causes of itching are:
- allergic reaction to the administered drug;
- infectious lesion of the solution injection area;
- weakened immunity after infectious diseases or surgery;
- skin contact with water.
Infection occurs when the papule is touched with unwashed hands. As a result, inflammation increases, but it usually goes away on its own and does not require therapeutic measures.
If due to infection and inflammation it is not possible to evaluate the Mantoux result, then the test is repeated after a certain period.
What could this mean?
If the Mantoux area itches, the body is not necessarily affected by tuberculosis. Itching is not a clear sign of infection. The likelihood of disease is judged by the size of the Mantoux redness, and not by itching.
But if 72 hours have not yet passed after the injection, and the button is very swollen and red, and begins to itch intensely, you need to go to a phthisiatrician. The doctor will determine whether the patient has tuberculosis or whether the Mantoux test is false positive.
Is it possible to scratch?
Is it possible to scratch Mantu? Regardless of the reasons for the itching and how intense it is, scratching the Mantoux area is strictly prohibited. With constant scratching, the area of redness increases, a papule does not form, and the swelling intensifies.
For example, in very young children you can observe that the hand is completely swollen. If there is no allergic reaction to tuberculin, then severe itching can be avoided by avoiding contact with water; for this reason, doctors do not recommend wetting the reaction area for three days.
What happens if you comb Manta? As mentioned above, such actions lead to an increase in the reaction zone, increased swelling and redness. This can lead to distortion of the test results, since 72 hours after the injection, the doctor uses a ruler to measure the size of the papule, and depending on this, makes a conclusion about the presence of the disease. If you scratch Mantu, the result will be distorted.
Why can't you scratch Mantu other than this? Scratching can lead to infection in the wound and the development of inflammation. Not only is this in itself, although not dangerous, not very good, it can also distort the results of the study.
Why does Mantoux itch and what to do if a child scratches the vaccine
When is a test prescribed and the Mantoux test performed?
Therefore, Mantoux is prescribed to adults in cases where:
- There were suspicions of an active form of tuberculosis.
- There was contact with patients without proper protection.
- Re-vaccination with BCG is forthcoming.
The hazard assessment is given depending on:
- swelling;
- diameter;
- brightness of the spot.
What to do if the reaction is positive?
By contacting a phthisiatrician, you:
- They will examine you and issue the necessary directions.
- You will be enrolled in the TB surveillance program, after which you can receive paid sick leave and are required to undergo a full medical examination within a week.
When to contact a phthisiatrician?
And you can even put off going to a specialist for lack of time, but only if there are no factors such as:
If any of the above took place, then postponing going to the doctor is dangerous to your health. After all, tuberculosis at an early stage is easier and faster to treat. Accordingly, it won’t be superfluous to be on the safe side once again, especially with such introductory information. Fluorography that was more than a month old will most likely have to be redone, and the deadline for conducting a repeated planned study will be taken from this moment, and not from the time of the previous test.
Commonly used for introduction:
- Left forearm in odd years.
- Right when it's even.
Results and types of reactions in children and adults
The injection analysis is carried out using the same parameters in adult and minor patients, the reaction is considered:
Why does the graft itch and swell?
This often goes away within 2-3 hours, but can last up to several days if:
- There are allergies and increased irritability, ADHD and other diseases of the nervous system, which is why the damaged area can “itch” a lot.
- The placebo effect occurs. The area itself may not itch, but the child, due to the ban on touching it, begins to irritate himself just to touch the redness.
But what to do if you don’t have the strength to endure the itching?
What to do if a child scratches Mantu?
Pay attention to:
- An increase in the size of the spot, while the swelling does not change or, on the contrary, decreases.
- Change in shape (swollen ball) of redness and its complete deformation or swelling.
Where is the test done and in what cases should you sound the alarm?
If:
- The child has been in contact with tuberculosis patients or lives in the same building with them.
- The swollen area has developed into an open ulcer and severe swelling is noticeable. Or it continues to swell a week after the readings were taken.
- An increase in temperature, difficulty breathing and a persistent cough were noticed.
Based on the test results, you will be prescribed a course of antibiotics and further treatment will be prescribed.
What to do if the reaction is positive?
But still, a positive result is not yet a specialist’s diagnosis and there is no reason to panic yet. If possible, you should contact a qualified doctor to provide a full diagnosis and issue directions for fluorography and other tests. Increased susceptibility to tuberculin occurs in a small percentage of people, but in relation to the total number of positive results it gives a large error in diagnosis and therefore is only a marker of whether the patient should undergo a full examination.
By contacting a phthisiatrician, you:
- They will examine you and issue the necessary directions.
- You will be enrolled in the TB surveillance program, after which you can receive paid sick leave and are required to undergo a full medical examination within a week.
First of all, you will have to take a sputum culture to look for Koch bacilli. After all, the size of the swelling is a poke in the sky, not allowing you to know the localization and duration of the disease, indicating only the very fact of the presence of Koch’s bacilli in your body. Accordingly, the results can be distorted for a number of reasons, starting with the fact that a fully grown person ignores the doctor’s advice and scratches the irritated area or allows drops of water to fall on it, and ending with defects in the immune system.
The reliability of the study is also affected by an allergic or chronic disease of an infectious nature, which worsened during this particular period. And also all infections suffered less than a month ago. Not to mention that changes in the body associated with aging, taking hormonal drugs and menstrual cycles can tilt the result in a positive direction. It can even be affected by the characteristics of the skin and the poor ecology of the environment, including the environment in which the test itself was made. More importantly, neuroses and depression only weaken your immune system, so excessive anxiety also becomes a culprit in distorting the results. Accordingly, you should not panic without reason, and you need to contact a phthisiatrician as soon as possible.
Mantoux itches in a child: what to do
If the Mantoux test is itchy in a child, then the only way to reduce the itching is to take an antihistamine. For example, Claritin syrup in a dose of 1 teaspoon for body weight up to 30 kg and 2 teaspoons for higher weight. The reception takes place once a day. This is usually completely enough to relieve irritation due to nonspecific allergies.
Long-sleeved clothing made from soft cotton fabric can also help. It is best to distract a capricious and suspicious child with games, a walk, or watching a movie. Parents should take care of their diet; citrus fruits, chocolate and nuts or other foods to which they were allergic in the past should be excluded.
If it is itchy and swollen
If the site of tuberculin injection is itchy and swollen, then one of the reasons is infection. A child may carry it when rubbing the injection site with dirty hands. In such cases, you cannot act on your own; you must immediately show your hand to the pediatrician.
He may prescribe treatment of the forearm with antiseptic solutions (Miramistin, Furacilin, Chlorhexidine), application of Levomekol ointment, Bepanten plus, Rescuer balm. In such cases, the sample should be redone.
Signs that a pronounced reaction to tuberculin was due to infection with tuberculosis are:
- papule size from 17 mm (15 and 16 mm are at risk);
- severe swelling and pain that persists for more than 2 days;
- the appearance of blisters or pinpoint blackening of the skin;
- enlarged lymph nodes or redness, hardening of the vessels carrying lymph (lymphadenitis and lymphangitis).
What not to do if the papule is itchy
In order not to disturb the results of Mantoux, if itching, you should not:
- lubricate the injection site with any external means (solutions or ointments);
- apply cold or heat;
- cover the papule with a plaster or bandage;
- rub with a towel after water procedures;
- Dress your child warmly to prevent sweating.
We recommend reading about the causes of Mantoux allergy. From the article you will learn about what provokes the development of allergies to the Mantoux vaccine, who is more susceptible to allergies among children, what to do if allergy symptoms appear in a child.
And here is more information about why the temperature may rise after Mantoux.
If a child scratches Mantu, this may lead to an incorrect assessment of the sample - the papule will increase in size more than it actually is. If the itching is tolerable, you can give Claritin or another allergy medication; with severe symptoms, you should contact your pediatrician.
What to do if it itches VERY badly?
What to do if Mantu itches so much that it is impossible to tolerate? The algorithm of actions is as follows:
- Give your child an antiallergic drug;
- Give an antihistamine;
- For young children, wearing a long-sleeved shirt can sometimes help, as the child may scratch the affected area simply because he sees it;
- Explain to your child that if he scratches the injection site, he will have to give another injection (and this is true).
You cannot treat the injection site with local medications to relieve swelling and itching, as this will distort the test results.