Diaskintest positive, negative. Photos of children, adults. Norma papules with explanations. Treatment, what to do: an X-ray tomography

Tuberculosis - a contagious disease, the causative agent of a tubercle bacillus. Annual screening for infection should receive all adults and children over 1 year. Survey methods can detect the disease at an early stage. Diaskintest - a reliable way to detect tuberculosis. A positive result - the basis for fluorography image of the lungs.

Methods for detection of infection

For the detection of tuberculosis all, regardless of social position, is assigned to annual screening. Method of diagnosis of the patient is determined by age. Early treatment in 70% of cases allows you to completely get rid of the parasite. In the absence of therapy increases the risk of death by 2 times.

The main methods of determining the presence of Koch's bacillus in the body:

• Tuberculin. It is used in children. Mantoux test is placed every year. Attenuated Mycobacterium is injected subcutaneously into the anterior surface of a forearm. The result is checked for 3 hours. Place of vaccination can not be combed and warm. The appearance of papules and degree of discoloration of the skin around allows conclusions about the presence or absence of infection in the body. In identifying infection in the body after the Mantoux child appoint Diaskintest. Treatment is possible only after the elimination of false positive reactions.
• X-ray and fluoroscopy lungs. Performed in patients older than 15 years. The survey generated image, on which the doctor will determine the pathology of the lungs. This method identifies tuberculosis at an early stage. In the photo mark the lesion, the disease form (primary or chronic tuberculosis). Contraindication method is pregnancy. For the other groups of the population radiation dose while taking a shot low and poses no danger to health.
  
• General blood analysis. It does not identify mycobacteria, but will show the presence of inflammation in the body. On this basis, the therapist will appoint an additional examination, including the exclusion of tuberculosis.
• PCR method. It detects the presence of mycobacteria in sputum. The children used to confirm the diagnosis. In adults, it is rarely used.
• Magnetic resonance imaging or computed tomography. It is used for diagnosis, identify the location and size of foci of inflammation. Compared with fluorography sensitivity above 100 times.
• Bacteriological examination of the bronchi. Determines the causative agent of tuberculosis. Do not use in children and the elderly.
• Bronchoscopy. It evaluates the degree of damage to the lungs, including the trachea and mucous membranes.

Characteristics of studies

Diaskintest - a way to determine tuberculosis. It is similar to the rules for diagnosis Mantoux reaction. The active substance - proteins of mycobacteria that do not infect humans. The accuracy Diaskintest higher than Mantoux test, but use it less often.

Mantoux test gives a positive response in the patient's propensity to allergies, and Diaskintest reduces the likelihood of similar situations.

Photo Diaskintest positive Mantoux test, and can be seen in a TB study. Significant visual differences between them will not have, but the positive outcome Diaskintest indicates that a person is infected with Mycobacterium.

After detection of the disease and the outcome of therapy undertaken becomes negative. But Diaskintest does not cause reactions in people who have previously received BCG vaccination. Therefore, it is not used for the selection of people who need revaccination.

What it is in solution

Diaskintest administered subcutaneously in the forearm. The body reacts to mycobacterial proteins. The method allows to determine whether a person is infected with TB. But this method can not distinguish whether the patient is a carrier of bacteria or disease progression occurs. With a positive sample and the absence of symptoms appoint additional methods of examination.

The structure Diaskintest includes:

• saline;
• artificial proteins tuberculosis bacteria and CFP10 ESAT6;
• sodium and potassium salts;
• preservative is phenol in an amount of 0.25 mg, which is safe dose;
• stabilizer polysorbate 80.

Features of the test

Procedure for Diaskintest and Mantoux reaction identical. Before the diagnosis is necessary to make sure that the patient is healthy and has no allergic reactions. Despite the fact that the test accuracy of 90%, an additional load on the immune system cause a false positive reaction.

Rules of Diaskintest:

• syringe for injection requires a fine needle;
• gaining dose;
• substance is administered subcutaneously into the inner part of the forearm;
• can be put in any hand, preference is given to the left;
• if the drug is administered after a positive result to the tuberculin test, then use the other arm;
• 3 day nurse evaluates the result, which identifies infected with tuberculosis or not a person.

Is it permitted to wet the sample

After the injection, you must follow some rules in order not to get an incorrect result. Place setting tests for TB can not comb, because it is likely to infect the wound and do not get the correct result.

Diaskintest watering is not recommended for people with sensitive skin and prone to allergic reactions.

This may provoke a false positive result. Sticking to this rule is necessary as long as the doctor did not examine the site of the injection.

All other wet forearm after the test, you can, but do not rub the washcloth, scrub and other agents that can damage the skin. Other restrictions on diet and lifestyle, this method does not provide diagnostics.

The frequency of diagnosis conducts

The frequency of injections depends on the age and health of the patient:

• Children to identify tuberculosis diagnosis prescribed 1 time per year, starting from 12 months. If the result is negative, then other diagnostic methods are not used.
• In adults, the main indicator of the lack of TB is X-ray or a chest X-ray light. The annual negative result does not mean setting Diaskintest. But there are exceptions.
• In identifying tuberculosis in employee health, children's and other institutions, Diaskintest put all employees of the company. According to the results determine whether there is still sick after contact at the company.
• With a positive Mantoux test in the following manner to identify the infection in the body is Diaskintest. When equivocal diagnosis can be repeated after 2 months.
  
• If a person is registered with a TB or is in a high risk group for the disease, a doctor may be appointed Diaskintest 3-6 months. But the interval between the diagnosis of tuberculosis and any vaccinations must be at least a month.

Determining whether the test pathology

The result after the injection is determined after 3 days. When viewed from the injection site doctor determines the amount of red spots and papules.

Depending on the magnitude of the detected degree evaluation indices:

Reaction	Papule	Redness
negative	absent	2 mm or less
dubious	4mm	present
positive	6 mm and more	present
hyperergic	more than 14 mm	the appearance of seals, bubbles, skin disorders

A positive result Diaskintest (photo below) was confirmed by a doctor's certificate. Papule from 5 to 14 mm indicates that the person is infected with mycobacteria.

A negative result indicates that the person is healthy. All other results of injections require additional diagnostics. With a negative test is no swelling, but it remains the injection site. A small hematoma occurs when poor-quality research that can influence the determination of the result.

If the physician determines the dubious reaction, the patient will be sent for re-test after 2 months. With a negative result, the child or adult can attend the team. Within a month banned raise vaccination against tuberculosis. Additional research methods do not use 12 months.

Positive answer

Diaskintest gives a positive result in the following cases:

• in the body there is an active inflammatory process progresses tuberculosis;
• People infected with mycobacteria, but the disease has not yet come;
• carrying out injection with contraindications, in this case, the result would be false positives.

More accurate identification of the stage of disease provides an X-ray picture. It shows inflammation in the lungs. If the disease has not yet occurred, then the photographs phthisiatrician see Gong hearth. Immunity to cope with Mycobacterium tuberculosis and is not developing. Therefore, the disease progresses with a decrease in the body's defenses, nutrition.

False positive test result

False positive reaction occurs if the injection was carried out under the following contraindications:

• Violation of the skin at the injection site, and wound infection.
• Availability of allergic reactions, amplification of atopic dermatitis.
• Autoimmune diseases.
• The presence of a viral infection. At the same time a manifestation of SARS could still not be.

People who are prone to allergic reactions, you should take antihistamines before the formulation of the vaccine. Prohibited use of alcohol, as this may cause redness at the site of injection.

Actions upon detection of infection

A positive result Diaskintest (photo stated below) is the base to direct the patient to consult a phthisiatrician. The doctor will give direction to the CBC. In the case of infection in blood leukocytes will decrease and the increase in ESR. Tuberculosis develops asymptomatically up to 2 years.

During this period, the patient is not contagious, but the fall of immunity disease moves into the open mold. Therefore, the physician shall promptly determine the stage of the disease and prescribe treatment to prevent the infection of others.

Adults need to undergo chest X-rays for the detection of foci of lung injury. X-ray examination is recommended for children due to lower radiation dose. If there are no pictures on the distinct foci of inflammation, lung MRI is required.

Therapy lung disease

TB treatment lasts 6-8 months. During this time, depending on the stage of the disease is necessary to observe the doctor's recommendation. In severe stage requires bed rest. With an average state of health to avoid physical exertion and stress. During the improvement can go to normal mode.

The time for which recovery occurs depends on the patient's immunity to mycobacteria resistance prescribers comorbidities.

The first line anti-TB drugs are:

• pyrazinamide - facilitates easy recovery;
  
• rifampicin - prevents contamination of healthy tissue;
• Streptomycin - blocking bacterial proteins;
• ethambutol - destroys the tubercle bacillus.

At this stage, combining drugs can stop the progression of the disease. The duration of treatment, dosing frequency and dose of the drug based on phthisiatrician determines tuberculosis assigned previously untreated and general condition of the patient.

In severe cases, the use of surgical methods. They are necessary for complex forms of the disease and the development of complications. By resorting to surgery 25% of all cases. Bleeding light is a life-threatening condition and requires immediate attention.

Depending on the development of the disease, the surgeon removes part of the body, the share of all light. Maybe cutting off the ruined site - cavity.

In the absence of treatment of tuberculosis mortality reaches 50%. This risk was higher in the elderly, HIV-infected patients with diabetes mellitus. During treatment, you can not take a break from taking drugs.

We do not recommend the photos on the Internet to determine the positive or negative result Diaskintest. In addition, during therapy require high-calorie diet and taking vitamins. When the active stage of the disease occurs in treatment TB clinic.

Registration of the article: Lozinski Oleg

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