LETTER
Tuberculin Skin Testing
John T. Flynn, MD
15 August 1997 | Volume 127 Issue 4 | Page 334
TO THE EDITOR:
The reliability of the tuberculin skin test depends not only on accurate measurement [1] but also on proper administration. The Mantoux technique [2] requires an intradermal injection, not a subcutaneous one. In addition to measurement of the resulting reaction, the patient should be asked whether the initial injection raised a sharply demarcated, painful blister at the needle site. Too often, inexperienced or inadequately instructed administrators inject the test material subcutaneously; the reaction is therefore mild and local, subsiding and even disappearing within the requisite 72 hours. This leads to an inappropriate reading and an inadequate evaluation of the patient's responsiveness. Because recommendations for prophylaxis so often depend on the reported result of the test, a check on the accuracy of the test administration is essential.
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Author and Article Information
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New York Downtown Hospital; New York, NY 10038
1. Pouchot J, Grasland A, Collet C, Coste J, Esdaile JM, Vincenaux P. Reliability of tuberculin skin test measurement. Ann Intern Med. 1997; 126:210-4.
2. Mantoux C. Lintradermo-reaction a la tuberculine et son interpretation clinique. La Presse Med. 1910; 18:10-3.
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