Name of the Procedure:

Skin Test; Tuberculosis, Intradermal Common name(s): Mantoux test, PPD test (Purified Protein Derivative test)

Summary

A skin test used to determine if a person has been exposed to the bacteria that cause tuberculosis (TB). A small amount of TB protein is injected just under the skin, usually on the forearm, and the area is checked for a reaction after 48-72 hours.

Purpose

The procedure diagnoses latent tuberculosis infection. The goal is to identify individuals who may need further testing or treatment for TB.

Indications

• Persistent cough
• Unexplained weight loss
• History of TB exposure
• Positive TB risk factors (e.g., weakened immune system, living in high-risk areas)
• Pre-employment or pre-school admission screening

Preparation

• No specific preparation is needed
• Inform the healthcare provider of any prior BCG vaccination
• Provide a comprehensive medical history, including any immune-suppressing conditions or medications

Procedure Description

1. Clean the skin on the forearm.
2. Inject a small amount of PPD just beneath the skin surface using a fine needle.
3. A small raised area or bump will appear at the injection site.
4. The patient must return within 48-72 hours for a healthcare professional to check the reaction.

Duration

The injection itself takes a few minutes, but the patient must return 2-3 days later for evaluation.

Setting

The procedure is typically performed in an outpatient clinic or a doctor's office.

Personnel

The procedure is typically administered by nurses or trained medical assistants.

Risks and Complications

• Minor pain or discomfort at the injection site
• Rare allergic reactions
• False positive or false negative results

Benefits

• Quick and relatively simple
• Helps identify individuals at risk of developing active TB
• Early diagnosis leads to prompt and effective treatment

Recovery

• No significant recovery time required
• Patients can resume normal activities immediately after the injection
• Avoid scratching or covering the test site with bandages

Alternatives

• Interferon-Gamma Release Assays (IGRAs), such as QuantiFERON-TB Gold test
• Chest X-ray and medical evaluation for active TB

Patient Experience

• Mild stinging or itching at the injection site
• Discomfort from the needle prick
• Post-procedure, avoid touching the test site to prevent irritation.