FIELD: medicine.
SUBSTANCE: for differential diagnosis of tuberculosis and non-specific pathology of respiratory organs in children and adolescents, a Mantoux tuberculin test with 2 TE PPD-L is performed on one arm, in which the reaction to the tuberculin test is determined after 72 hours. Negative reaction is recorded in the absence of infiltrate and hyperemia, questionable reaction in case of an infiltrate with a diameter of 2-4 mm or only hyperemia of any size. Positive reaction is recorded in the presence of an infiltrate with a diameter of 5 mm and more or sharply positive reaction with an infiltrate diameter of 17 mm, as well as if vesicle, lymphangitis or regional lymphadenitis appear, regardless of the infiltrate size. Simultaneously with the Mantoux tuberculin test, a skin test with a tuberculous recombinant Diaskintest allergen is carried out on the other arm of the patient. 72 hours later, simultaneously with the determination of the reaction to the Mantoux tuberculin test, the reaction to the skin test with Diaskintest is determined. Negative reaction is recorded in the absence of a trace or a spot trace or a bruise less than 2 mm, questionable reaction in case of hyperemia of any size. Positive reaction is recorded in the presence of papules of any size. Then, a combined evaluation of the results of the reaction to the Mantoux test and the results of the reaction to the skin test with Diaskintest is carried out. With negative results for both tests, either the absence of infection with tuberculosis mycobacteria, or as a result of the use of hormones,α cytotoxic agents, TNF blockers, or immunocompromised disease, or infectious anergy due to severe tuberculosis is diagnosed. With a positive result of the reaction to the Mantoux test and a negative result of the reaction to the skin test with Diaskintest, a nontuberculous respiratory disease and lack of anergy are diagnosed. With positive results of the reactions to both tests active tuberculosis is diagnosed.
EFFECT: increased reliability of differential diagnosis of these diseases.
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Authors
Dates
2017-10-11—Published
2016-07-13—Filed