The Mantoux test is a screening tool for tuberculosis (TB). It is one of the major tuberculin skin tests used around the world, largely replacing multiple-puncture tests such as the Tine test. The Heaf test was used until 2005 in the UK, when it was replaced by the Mantoux test. It is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention. It was also used in the USSR and is now prevalent in most of the former Soviet states.
Tuberculin is a glycerol extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a precipitate of species-nonspecific molecules obtained from filtrates of sterilized, concentrated cultures. The tuberculin reaction was first described by Robert Koch in 1890. The test was first developed and described by the German physician Felix Mendel in 1908 It is named after Charles Mantoux, a French physician who built on the work of Koch and Clemens von Pirquet to create his test in 1907.
In 1939, M. A. Linnikova in the USSR created a modified version of PPD. In 1954, the Soviet Union started mass production of PPD-L, named after Linnikova.
Procedure
A standard dose of 5 tuberculin units (TU - 0.1 ml) (The standard Mantoux test in the UK consists of an intradermal injection of 2 TU of Statens Serum Institute (SSI) tuberculin RT23 in 0.1 ml solution for injection.) is injected intradermally (between the layers of dermis) and read 48 to 72 hours later. This intradermal injection is termed the Mantoux technique. A person who has been exposed to the bacteria is expected to mount an immune response in the skin containing the bacterial proteins.
The reaction is read by measuring the diameter of induration (palpable raised, hardened area) across the forearm (perpendicular to the long axis) in millimeters. If there is no induration, the result should be recorded as "0 mm". Erythema (redness) should not be measured.
