Skin test; tuberculosis, intradermal
CPT4 code
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
- Clean the skin on the forearm.
- Inject a small amount of PPD just beneath the skin surface using a fine needle.
- A small raised area or bump will appear at the injection site.
- 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.