Académique Documents
Professionnel Documents
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History
Tuberculin is an extract of tubercle bacilli Robert Koch 1890: TB remedy Clemen von Pirquet 1890s: TB immunity Seibert 1930s: PPD
Mantoux test
ID, 0.1ml of PPD, 5TU Reading after 48-72 h Induration Positive: 10 mm
Five years ago 32 ys old lady , pregnant 3rd trimester R. cervical lymphadenopathy TB skin test: positive Anti TB
Two weeks ago R. thyroid swelling Ultrasound: Mass with breakdowns TB skin test: positive Referral to chest clinic for anti TB
Natural history
Organism: Myc. tuberculosis Entry
Respiratory tract Alimentary tract Skin
Immune response
Cell-mediated immunity Delayedtype hypersensitivity
Latent TB Infection
No symptoms No spread of infection Radiology ? Microbiology: -ve
TB Disease
Symptoms: +ve May spread infection Radiology: abnormal Microbiology: positive
TB skin test: Positive (usually)
Old Healed TB
May have radiographic findings No symptoms or symptoms related to fibrosis TB skin test: Positive (Usually)
Facts
Searching for diseases? Positive TB skin test indicates infection; not necessarily disease
Facts
Screening for infection?
and testing
the greater is likelihood that the reaction represents infection with M.tuberculosis
TB blood test?
IFN- release assays (IGRAs)
QuantiFeron-TB Gold or T Spot-TB
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