Diaskintest results: normal, positive, negative. Diaskintest - what does it show? Indications, side effects, preparation and conduct of the test for a child and an adult, results (photos of positive and negative reactions, norm), reviews

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Diaskintest represents skin test designed for diagnostics tuberculosis and assess the activity of existing pathological process. The test allows you to identify how active tuberculosis various bodies(lungs, kidneys, etc.), and asymptomatic carriage, when the disease is absent, but there is infection with mycobacteria (M. tuberculosis).

Diaskintest - what is it (essence and general principles)

Diaskintest is a method for diagnosing tuberculosis, according to the principle of its implementation, similar to the Mantoux test, and in fact the reaction occurring in the body - to the quantiferon test. Let's take a closer look at what this means. So, to set up a diaskintest, a liquid containing proteins that are present on the pathogenic bacteria Mycobacterium tuberculosis is injected intradermally, disease-causing tuberculosis. Since only individual proteins are injected intradermally, diaskintest in no case can lead to infection with tuberculosis.

And then, after three days (72 hours), the reaction of the body in the injection area is assessed by the presence of redness, seals, etc. If there is a reaction in the form of redness or induration at the injection site, then the result of the diaskintest is considered positive. If only a point from the skin puncture with a needle is visible at the injection site, then the test result is negative.

A positive diaskintest result means that the human body is familiar with Mycobacterium tuberculosis, that is, it the immune system"recognized" the characteristic proteins introduced intradermally and gave an appropriate response to them. But unfortunately, positive result The test does not allow to distinguish active tuberculosis from asymptomatic carriage of mycobacteria, and therefore, with such a result of the diaskintest, an additional examination will have to be carried out in order to detect / exclude active tuberculosis.

A negative test result means that the human body is not familiar with Mycobacterium tuberculosis, that is, the immune system "did not recognize" foreign proteins introduced under the skin, and, accordingly, he is not sick with tuberculosis and is not an asymptomatic carrier of mycobacteria.

A positive or negative result of the diaskintest depends on whether the human body reacts to the proteins of mycobacteria introduced under the skin, which are called CFP10 and ESAT6. These proteins are found on the surface of the mycobacteria that cause tuberculosis and are considered antigens. If such proteins are introduced into the body (in the case of diaskintest, they are administered intradermally), then the immune system will first try to recognize them ("recognize"). And if the immune cells "recognize" the proteins of mycobacteria, they will immediately begin to produce antibodies to destroy the foreign genetic material that has entered the body, which will manifest itself as a positive result of the diaskintest.

But the "recognition" of proteins of mycobacteria depends on whether mycobacterium tuberculosis themselves have previously entered the human body. That is, if in the past a person was infected with mycobacteria, then immune cells "recognize" them, quickly develop antibodies, which will manifest itself as a positive reaction to diaskintest. If in the past a person was not infected with mycobacteria, then immune cells will not be able to "recognize" proteins introduced intradermally, which will manifest itself as a negative reaction to diaskintest.

Thus, it is obvious that a positive diaskintest result is observed in those people who have mycobacteria in the body. A negative result of diaskintest, respectively, is characteristic of those who have never been infected with mycobacteria. But a positive result does not necessarily mean tuberculosis, but only indicates infection with mycobacteria. Here, in order to understand this fact, it is necessary to make an explanatory digression.

Thus, mycobacteria are widespread and approximately 90% of the adult population of Russia are infected with them. Features of the structure and life cycle Mycobacteria lead to the fact that after entering the human body, they remain in it for life, since they are almost impossible to remove with the help of antibiotics available in the arsenal of modern medicine. But due to the complexity of the life cycle and the interaction of mycobacteria with the human body, such infection by them leads to the development of tuberculosis by no means always, but, on the contrary, even very rarely. So, according to modern statistics, among all people infected with mycobacteria, tuberculosis develops on average only in 2% (in risk groups - in 5-10%). That is, the vast majority of those infected with mycobacteria will live their whole lives quite calmly and will never get sick with tuberculosis. But in reality, only 2-10% of people infected with mycobacteria fall ill during their lifetime.

The condition when a person is infected with any pathogenic bacteria, but he does not have the disease caused by them, is called asymptomatic carrier. A person infected with mycobacteria does not release them into the environment and, accordingly, is not a source of infection for other people. Currently, in connection with the campaign announced by the WHO (World Health Organization) to minimize the incidence of tuberculosis, the state of asymptomatic bacteriocarrier, when there are mycobacteria in the body, but there is no active tuberculosis, is called latent tuberculosis infection. Recommendations have been made that people with latent TB infection should be treated prophylactically with anti-TB antibiotics to prevent them from developing TB in the future. Similar recommendations have been adopted in many countries, including Russia.

Thus, diaskintest makes it possible to detect the presence of mycobacterium tuberculosis in the human body, but the test does not make it possible to distinguish active tuberculosis from asymptomatic carriage. Therefore, as additional methods examinations to distinguish carriage from active tuberculosis with a positive diaskintest, X-ray / fluorography, computed tomography, ultrasound, urinalysis for mycobacteria, etc. are prescribed.

Sensitivity and specificity of diaskintest

The sensitivity of the method reflects the percentage of cases where it gives a negative result in the presence of infection with mycobacteria. That is, the sensitivity of diaskintest is the percentage of false negative results when the sample is negative, but in reality the person is infected with mycobacteria. According to various studies, the sensitivity of diaskintest is 78 - 96%. This means that the test can give a false negative result in people infected with mycobacteria in 4 - 12% of cases. Usually, false-negative results of diaskintest are recorded in people suffering from immunodeficiency, for example, against the background of HIV, immunosuppressive drug therapy, severe course of any disease, etc.

The specificity of the method reflects the percentage of cases where it gives a positive result in the absence of infection with mycobacteria. That is, the specificity of diaskintest is the percentage of false positive results. The specificity of diaskintest, in contrast to sensitivity, is quite high, and amounts to 98 - 99%. This means that diaskintest gives a false positive result in only 1 person out of 100. False positive results are due to the fact that a person can be infected with certain types of mycobacteria (M. kansasii, M. leprae, M. marinum), which never cause tuberculosis, and cause other diseases. But these non-tuberculous mycobacteria also have ESAT-6, CFP-10 proteins on their surface, to the introduction of which the human body reacts during the diaskintest, giving a positive test result.

What does diaskintest show (its purpose)

Diaskintest shows whether a person is infected with mycobacteria that can cause tuberculosis. If the test result is positive, then infection with mycobacteria takes place. If the test result is negative, then the person is not infected with mycobacteria.

Unfortunately, diaskintest does not allow you to determine whether there is simply infection with mycobacteria (a person is a carrier of bacteria, but does not have tuberculosis), or whether a person has tuberculosis. To distinguish asymptomatic carriage of mycobacteria from active tuberculosis disease, additional examinations (X-ray, tomography, blood and urine tests, etc.) will be required.

In addition, diaskintest makes it possible to distinguish whether a positive Mantoux test is due to an allergy to tuberculin, or a previous BCG vaccination, or infection with mycobacteria. If the Mantoux test is positive due to an allergy or BCG vaccination in the past, then the diaskintest in such a person will be negative. But if the Mantoux test is positive due to infection with mycobacteria, then the diaskintest in such a person will also be positive, which will confirm the Mantoux result.

In addition, Diaskintest allows you to monitor the effectiveness of ongoing anti-tuberculosis therapy. After treatment of active tuberculosis or after prophylactic treatment, if they were effective, diaskintest becomes negative.

However, given the fact that the administration of the drug diaskintest does not cause a reaction in people who have received a BCG vaccination in the past, the result of this examination cannot be used to select children and adults for repeated BCG vaccination.

Indications and contraindications for diaskintest

Diaskintest is indicated for intradermal testing in people of all ages with the following goals:

• Diagnosis of active tuberculosis of various organs (lungs, kidneys, lymph nodes etc.);
• Identification of people at high risk of developing active tuberculosis of any organ (infected with mycobacteria or, as this condition is called in official documents, with "latent tuberculosis infection");
• For the purpose of differential diagnosis allergic reaction for the Mantoux test (after BCG vaccination or against the background of an allergic constitution of the body) and tuberculosis;
• To evaluate the effectiveness of ongoing tuberculosis treatment and preventive therapy.

At present, according to the orders of the Ministry of Health, diaskintest as a method for diagnosing tuberculosis is mandatory for all healthy children 8-18 years old once a year (instead of the Mantoux test). If the child has not received BCG vaccinations, then diaskintest is done twice a year. Diaskintest can also be prescribed for the diagnosis of tuberculosis and for adults as part of a preventive examination. If a child or adult is registered with a phthisiatrician, then diaskintest can be prescribed once every 3 to 6 months.

In addition, diaskintest is indicated for a dubious result of the Mantoux test, when it is necessary to understand whether a positive or dubious Mantoux result is due to allergies, BCG vaccination, or developing tuberculosis.

Diaskintest is contraindicated in the following diseases and conditions:

• Availability skin diseases with a large number of rashes, pustules, etc.;
• Acute period of any disease, including SARS, tonsillitis, colds, etc.;
• Exacerbation of the various chronic diseases any organs;
• The period of exacerbation of allergic diseases;
• Quarantine for infections in institutions where a person works or studies;
• Vaccination within a month before the diaskintest;
• Individual intolerance or allergic reaction to the components of diaskintest.

If at the time of the test there is a high probability of contracting an infectious disease (for example, influenza, SARS, etc.), then it is better to postpone the diaskintest, since in such a situation, when the infection has already occurred, but the disease has not yet developed, the risk of a false positive result is very high. Diaskintest is done two months after an acute infection, for example, scarlet fever, bronchitis, etc.

Since the effect of the drug diaskintest on the course of pregnancy and fetal development has not been studied, diaskintest is used in pregnant women as part of a comprehensive diagnosis of tuberculosis only in cases where the benefit outweighs the potential risk to the unborn child.

How often do diaskintest?

Healthy children aged 8-18 years old are given diaskintest once a year as part of a mass examination to detect tuberculosis. If the child has not received a BCG vaccination, then diaskintest is done twice a year. Adult diaskintest is also done once a year as part of a preventive examination. But if a child or an adult suffers from diabetes mellitus, peptic ulcer of the stomach or duodenum, diseases of the bronchi, lungs or kidneys, HIV infection, receive immunosuppressive drugs, then diaskintest is performed as part of a preventive examination twice a year, every 6 months.

Children are allowed to put diaskintest with a positive Mantoux test from the age of one year.

In all other cases, the frequency of diaskintest staging is determined by the doctor, and at the same time he is guided by the following rules:

• If the diaskintest result is negative, the test can be repeated after 2 months;
• With a positive result, diaskintest can be repeated at any time intervals as necessary;
• After setting any vaccination - not earlier than a month;
• After suffering any acute infectious diseases - not earlier than a month later.

Side effects of diaskintest

Diaskintest can provoke the development of the following side effects:

• General malaise;
• Increase in body temperature;
• A bruise or abscess at the injection site;
• Allergic reaction (urticaria, itching of the skin all over the body, shortness of breath, redness of the eyes, swelling of the mucous membrane of the nasopharynx, etc.);
• Pressure surges (especially typical for older people).

Usually side effects short-lived and pass on their own within a few hours or days. If a severe allergic reaction develops, then antihistamines should be taken (Erius, Telfast, Zirtek, Claritin, Fenistil, etc.). If an abscess appears in the injection area, then you need to urgently consult a doctor, as this indicates that pathogenic bacteria have entered the wound and become infected.

In some cases, diaskintest can cause a so-called hyperergic (excessively strong) reaction, which manifests itself in the formation of a large papule (more than 15 mm in diameter), swelling and irritation around the injection area, the formation of vesicles and pustules on the skin, inflammation of the lymph nodes. Such a hyperergic reaction is considered conditionally positive, but can also be attributed to the side effects of diaskintest.

Why is diaskintest dangerous?

Theoretically, diaskintest is safe, as it does not contain any components recognized as hazardous to health. However, since the solution contains protein molecules, the sample can cause allergic reactions, including violent ones. It is in the development of a violent allergic reaction that the main danger of diaskintest lies. If within a short time after the injection, the eyes turn red, itching of the skin appears, the nasopharyngeal mucosa swells, or blisters and severe swelling form on the skin of any part of the body, then this indicates a rapid course of an allergic reaction, and in this case it is necessary to consult a doctor.

Diaskintest and Mantoux

Diaskintest and Mantoux test are skin tests for the early detection of tuberculosis, when a person may still lack characteristic symptoms diseases. The Mantoux test has been known and used for a very long time, but Diaskintest is a new study. Both tests (Mantoux and Diaskin) are skin tests, that is, for their production, a preparation is injected intradermally containing some substances to which the human body reacts.

The Mantoux test contains tuberculin, a substance produced by mycobacteria in the course of life, and therefore, when it is introduced into the body, a positive reaction occurs in those people who have active tuberculosis. But, unfortunately, the Mantoux test gives a high percentage of false positive results, since a positive reaction may not be due to the presence of tuberculosis in a person, but to a previous BCG vaccination, an allergy to tuberculin, etc. Diaskintest, unlike the Mantoux test, contains only proteins shell of mycobacteria, therefore, does not give a false positive reaction to a previous BCG vaccination or a person's allergy. That is, diaskintest, unlike Mantoux, gives a lower percentage of false positive results and registers only the presence of mycobacteria in the body, and not allergies or passive immunity cells developed after BCG vaccination. As for setting, indications, contraindications and accounting for results, the Mantoux test and diaskintest are completely similar.

Despite certain advantages of diaskintest over the Mantoux test (greater accuracy with fewer false positives), this study still has disadvantages. So, at an early stage of infection and development of tuberculosis, diaskintest gives a negative result, and the Mantoux test is positive. That is, the earliest stages of tuberculosis can be detected using the Mantoux test, and diaskintest is useless in such cases.

In principle, due to false negative results in the early stages of tuberculosis development, diaskintest does not completely replace the Mantoux test. Therefore, experienced doctors advise doing both skin tests at the same time on different hands.

If there is a turn of the Mantoux test (a large increase in the size of the papule), then it is advisable to do a diaskintest. If the diaskintest in such a situation is negative, then it is recommended to repeat it after two months to make sure that the positive Mantoux is not due to an early stage in the development of tuberculosis, but to an allergy or BCG vaccination in the past. But if, against the background of the Mantoux turn, diaskintest is positive, then this is evidence of infection with mycobacteria and, accordingly, an indication for preventive treatment.

Thus, it is obvious that the Mantoux test and Diaskintest have their own pros and cons, their results partially duplicate each other, and partially do not, therefore, it is logical to consider these tests as complementary, and not competing. That is why, even knowing full well all its imperfections, doctors still use the Mantoux test for the early diagnosis of tuberculosis in children, and diaskintest is used as an additional clarifying method.

Unfortunately, the disadvantage of diaskintest is the fact that it often causes excessively strong reactions (hyperergic), which are also an indication for a subsequent full and detailed examination in order to detect active tuberculosis. A hyperergic reaction to diaskintest can be manifested by inflammation of the lymphatic vessels, the formation of vesicles or pustules on the skin. Similar excessive reactions in diaskintest, according to researchers from the Mordovian State University them. Ogarev, are observed in 30% of cases, and in the Mantoux test - only in 1.5% of cases. This fact means that if a hyperergic reaction to diaskintest is detected, it should not be used in the future in order to avoid the development of skin test complications.

Preparation for diaskintest

It is advisable to plan Diaskintest before vaccinations, since if vaccination has been performed, then after it you need to wait at least a month before testing for tuberculosis. And if diaskintest is carried out before vaccinations, then they (except for BCG) can be placed immediately after taking into account the result of a skin test, provided that its result is negative. But if the diaskintest is positive or doubtful, then any vaccinations can be given no earlier than six months later.

If an adult or child suffers from allergic reactions to any substances (food, medicines, plant pollen, etc.), then diaskintest should be done under the guise of taking antihistamines (Erius, Telfast, Fenistil, Parlazin, Cetrin, Claritin, etc.). It is recommended to take antihistamines for 7 days - 5 days before the test and two days after. That is, a person begins to take antihistamines, on the fifth day a diaskintest is done, after which antihistamines are taken for another two days (in fact, before taking into account the results of the test).

Before setting up a diaskintest, adults should refrain from drinking alcohol for 2 to 3 days and then until the results are taken into account. Any other special preparation before the test is not required. You can lead a normal life, eat your favorite foods, etc.

Where to do diaskintest?

Diaskintest can be done at the following healthcare facilities:

• Ordinary municipal polyclinic;
• TB Dispensary;
• Hospitals and sanatoriums specialized in the diagnosis and treatment of tuberculosis;
• Research Institute of Tuberculosis or Epidemiology;
• Private medical centers working on the profile of immunoprophylaxis.

Sign up for Diaskintest

To make an appointment with a doctor or diagnostics, you just need to call a single phone number
+7 495 488-20-52 in Moscow

+7 812 416-38-96 in St. Petersburg

The operator will listen to you and redirect the call to the right clinic, or take an order for an appointment with the specialist you need.

How to do diaskintest?

Diaskintest is done in a clinic, tuberculosis dispensary or in private centers involved in immunoprophylaxis (vaccination). To set up the test, the solution is injected strictly intradermally in the region of the lower third of the inner surface of the forearm. Moreover, they try to use the non-working hand, that is, the left hand for right-handers and the right hand for left-handers.

For diaskintest, disposable tuberculin syringes with thin needles and with an oblique cut are taken. Before using syringes, their expiration date must be checked. After preparing the syringes, a set of the drug is carried out. To do this, wipe the rubber stopper of the vial with a solution for diaskintest with gauze moistened with alcohol. Next, the cork is pierced with a needle, the solution is drawn into the syringe in an amount of 0.2 ml, the needle is removed and replaced with a new one. After that, to remove air, the syringe is held with the needle up and lightly tapped on its wall with a fingernail so that the bubbles come off the walls and collect on the surface of the solution. Then, to remove this air, a part of the solution is released into a cotton swab so that 0.1 ml remains in the syringe.

The person is seated on a chair in a comfortable position, the forearm is exposed and the skin of its inner surface is wiped with a cotton swab moistened with 70% alcohol. After that, the skin is dried with a sterile cotton swab. Then, a needle is inserted into the skin of the lower third of the inner surface of the forearm with a cut up by 3-4 mm. Before insertion, the skin is stretched and the needle is inserted parallel to the skin surface. Then, by pressing the plunger, 0.1 ml of the solution is injected from the syringe strictly intradermally. At the site of injection of the solution on the skin, a "lemon crust" with a diameter of 7 - 9 mm, painted white, is formed.

The vial after taking the first dose of the solution is stored under sterile conditions for a maximum of two hours.

The result of the diaskintest is evaluated 72 hours (three days) after the test. To evaluate the result, the doctor or nurse inspect the injection site for the presence of papules (seals) or redness in it. Papule or redness is measured with a transparent ruler with millimeter divisions. The diameter of the formed papule and redness around it is measured. If there is no papule, then the diameter of the redness is measured. In this case, the result is considered doubtful if there is redness or a papule with a diameter of 2–4 mm. A positive test is considered when the size of the papule is more than 5 mm. The result is considered hyperergic (with an overly strong reaction) in the presence of vesicles, necrosis, inflammation of the lymph nodes in the injection area, regardless of whether there is a papule. Moreover, a hyperergic reaction also refers to positive ones. If at the injection site there is only a point from the injection, then the result of the diaskintest is considered negative.

Is it possible to wet diaskintest?

Yes, the injection site of the diaskintest can be wetted. That is, after setting a skin test, it is allowed to swim, but at the same time it is impossible to apply detergents directly to the injection site and rub it with a washcloth.

It should also be remembered that the place where the sample was placed should not be rubbed with hands or any objects, scratched, sealed with plaster, rewound with a bandage, lubricated with brilliant green or other medicines, apply cosmetics and perfumes. To avoid itching of the test site, it is recommended that long-sleeved clothing made of fabrics that irritate the skin (for example, prickly or fleecy wool, etc.) should not be worn after the test.

In addition, in order to avoid a false positive result, within three days after setting up the diaskintest (before the result is taken into account), it is not recommended to steam in the bath and sauna, sunbathe on open beaches and in the solarium, swim in the pool and natural reservoirs, engage in active sports, stay for a long time on frost. These recommendations are due to the fact that high and low temperature environment, sweat, dirty water and dust can cause infection or irritation of the injection site, resulting in a hyperergic or false positive reaction.

Diaskintest - reaction (diaskintest results)

What might be the results

The result of the diaskintest is evaluated 72 hours after the injection of the solution and may be positive, negative or questionable, depending on the appearance of the injection site.

A negative diaskintest result is considered in the following cases:

• There is no papule (seal) or redness at the injection site, and only the point from the injection is visible;
• At the injection site, the so-called "prick reaction" is visible in the form of a bruise 2-3 mm in diameter.

The result of diaskintest is considered doubtful in the following case: at the injection site there is redness of any size without papule (seal).

A positive diaskintest result is considered in the following cases:

• At the injection site, there is only a papule (seal) with or without redness less than 5 mm in diameter (a mild positive reaction);
• At the injection site, there is a papule with or without redness, 5–9 mm in diameter (moderately positive reaction);
• At the injection site there is a papule with / without redness with a diameter of 10 - 15 mm (pronounced positive reaction);
• At the injection site, there is a papule more than 15 mm in diameter, or a papule of any size is combined with blisters, ulcers, inflammation of any lymph nodes and lymphatic vessels (hyperergic reaction, that is, sharply positive, excessively strong).

Diaskintest - norm, positive, negative

Normally, when a person is not sick with tuberculosis and is not infected with mycobacteria, the reaction to diaskintest should be negative. Positive (including hyperergic) and doubtful reactions to diaskintest are abnormal, as they indicate the presence of mycobacteria in the human body. Positive and doubtful reactions are considered grounds for referring a child or adult to a consultation with a phthisiatrician for the purpose of additional examination for the detection of active tuberculosis.

Photo of diaskintest

This photo shows a positive diaskintest result.


This photo shows the hyperergic result of diaskintest.



This photo shows the dubious result of diaskintest.



This photo shows a negative diaskintest result in the form of a bruise.



This photo shows a negative diaskintest result in the form of an injection mark.

Diaskintest reaction by day

The reaction of diaskintest by day is not significant, since the result should be evaluated only 72 hours after the injection - not earlier and not later. However, during the first hours after the test, redness and itching may appear, indicating an allergic reaction. Such manifestations of allergy usually disappear after 48 - 72 hours and, accordingly, do not interfere with the evaluation of the test results.

In addition, redness or papule may form already during the first or second day after the injection, by the end of the third day becoming maximum in size and severity. It is due to the maximum severity of the reaction three days after the injection that the test result is taken into account 72 hours after the injection of the solution. After 72 hours after the diaskintest injection, all skin reactions will decrease until they disappear completely.

Bruise in the diaskintest area

A bruise in the diaskintest area may occur in some cases, but such a reaction is considered a variant of the norm. A bruise usually results from an injury blood vessel and leakage of a small amount of blood intradermally. A large bruise may interfere with the correct recording of the diaskintest result, therefore, in such a situation, the doctor may suggest re-testing after a while.

If diaskintest is positive in a child or adult

A positive and doubtful result of diaskintest indicates that a person is infected with mycobacteria. But at the same time, positive or doubtful results do not allow us to distinguish what is happening in a particular case - active tuberculosis or simply infection (which is recorded in 90% of the adult population of Russia), when a person is healthy and there is no disease itself. That is why, with a positive or doubtful result of the diaskintest, an adult or a child must be referred for a consultation with a phthisiatrician who deals with the treatment and diagnosis of tuberculosis.

The phthisiatrician prescribes comprehensive examination, which is necessary to distinguish active tuberculosis from infection. As part of the examination, X-rays are required / CT scan(depending on the capacity of the institution) chest, general analysis of blood and urine, bacteriological culture of urine. If a person coughs, then a sputum examination is also performed (bacteriological culture and microscopy). Additionally, ultrasound of the lymph nodes and internal organs can be prescribed.

If, as a result of the examination, active tuberculosis of any organs (lungs, kidneys, intrathoracic lymph nodes, bones, etc.) is detected in an adult or child, then the doctor treats infectious disease according to the protocols approved by the Ministry of Health. Antibiotics are prescribed for treatment, which must be taken according to the scheme indicated by the doctor for several months.

If, with a positive result of diaskintest, the examination did not reveal active tuberculosis, then the person is considered infected with mycobacteria. This condition is currently called a latent tuberculosis infection (according to the WHO definition), and although a person in such a state does not suffer from tuberculosis, is not dangerous to others, since it does not release mycobacteria into the environment, nevertheless, the federal recommendations of the chief phthisiatrician of Russia say, that it is necessary to carry out prophylactic treatment with anti-tuberculosis antibiotics. The goal of prophylactic treatment is to reduce the risk of an infected person developing active TB in the future.

If a person refuses preventive treatment, then he will be registered in tuberculosis dispensary and will periodically (once every 3 to 6 months) repeat diaskintest. Most often in such cases, over the next year and a half, diaskintest becomes negative, and this indicates that the body has completely suppressed the activity of mycobacteria, and now the person is healthy. However, if the diaskintest remains positive for a year and a half, this indicates that mycobacteria are not suppressed, and in this case, although the person does not have tuberculosis, he has a high risk of developing this infection. When diaskintest remains positive for 1.5 years of observation in a tuberculosis dispensary, the doctor will again recommend a course of prophylactic antibiotic treatment.

Diaskintest alternative

An alternative to diaskintest as a method for diagnosing tuberculosis is the quantiferon test and the T-spot test, which are also based on determining the reaction of the body in response to the introduction of mycobacterium proteins. But in the course of performing the quantiferon and T-spot test, proteins are not injected intradermally, but blood is taken, and the entire reaction is carried out in a test tube.

Diaskintest - reviews

Most of the reviews on diaskintest (90% or more) are positive, since this test allowed parents to identify or exclude tuberculosis in children, which was suspected on the basis of a positive (bad) Mantoux. The reviews note that diaskintest allows you to understand whether there is an active tuberculosis process in the body or whether a positive Mantoux test is due to an allergy / response to a BCG vaccination. In addition, parents indicate that diaskintest allowed them to gain peace of mind regarding the health of the child or to detect tuberculosis at an early stage.

There are few negative reviews about diaskintest and they are mainly due to strong adverse reactions in response to drug administration.

Diagnosis of tuberculosis in children: x-ray of the lungs, tuberculin diagnostics, diaskintest - video

Before use, you should consult with a specialist.

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Examination of the population for the presence of tuberculosis is carried out using Mantoux. This TB test has been used for over 100 years, but is now modern drug"", which is considered more efficient. What should be Diaskintest in the norm, what are the deviations, and what should be done when they appear?

How long does it take to evaluate results?

Fluorography is used to detect pathology in the adult population. It is not done to children, so it remains only to use Diaskintest. Compared to the Mantoux test, it gives a positive result only in the presence of active causative agents of tuberculosis.

The interpretation of the results is carried out only after three days, although the reaction of the body will be noticeable almost immediately. Over the course of several days, the picture will change.

Evaluation of results

After diaskintest is done in adults or babies, the decoding consists in examining the injection site for swelling, redness and infiltration.

Normal result

The reaction to diaskintest gradually changes by day, the presence of a pathogen in the body is judged by changes and signs.

There is practically no reaction to diaskintest on the first day, but if the drug is unsuccessfully injected, a bruise or reddish spot may appear at the injection site without signs of compaction or swelling. The first reaction in the photo looks like this:

On the second day, the symptoms change. Normally, there is only a prick reaction at the injection site, even if there was redness on the first day. You may also notice a resolving bruise, if any.

The result on diaskintest in a child, as in an adult on the third day, will finally show the reaction of the body, by which the doctor judges the presence of a pathogen. A normal reaction is a barely noticeable needle stick mark or remnants of transient redness.

False positive result

Diaskintest can also give a false positive result. In this case, after the injection of the drug, hyperemia develops at the injection site, but the papule does not form. In such situations, you should not immediately panic, you need to undergo additional examinations, for adults, fluorography and a second Diaskintest are required after 2 months.

In the photo, the result looks like this:

There is also a dubious result of Diaskintest, when redness appears at the injection site, but the infiltrate either does not form at all or has dimensions of no more than 4 mm. Also, the doctor may doubt if there is a large bruise, against which it is difficult to see and assess the degree of redness.

Positive result

If the doctor tries to evaluate the result on the third day after the administration of the drug and sees severe redness, swelling, then a deviation from the norm is immediately noted, and the sample is considered positive.

But even a positive result can be different:

• The size of the papule is not more than 5 mm.
• Moderately positive result - the diameter of the papule ranges from 6 to 10 mm.
• A pronounced form is noted with sizes within 15 mm.
• A strongly pronounced result is a large diameter of the papule, more than 15 mm.

There have been cases when patients, even with severe deviations from the norm, turned out to be completely healthy, so do not panic ahead of time.

hyperergic reaction

Among phthisiatricians, there is another term for checking the results - a hyperergic reaction to Diaskintest. If such an assessment is given, then it means not just a positive result, but too exaggerated.

Not only after the injection, redness and severe swelling appear, but the size of the papule is huge, can reach 20 mm. Surrounding tissues around the injection site become inflamed and irritation develops.

Such a reaction may indicate either an excessive sensitivity of the body to the components of the drug or active development pathology in the body. But in any case, the patient should be referred for further examination to a specialized TB dispensary.

Why might the results be false?

Not always a doubtful or false positive result indicates the presence of pathology. It can be obtained for the following reasons:

• Diaskintest was made without taking into account contraindications. For example, a viral infection developing in the body can give a false positive result.
• An infection has got into the injection site, which often happens in children who comb it.
• The presence of a tendency to allergies. Against this background, the body may give an inadequate response to the test.
• Autoimmune and somatic pathologies.
• Before Diaskintest, the child was given another vaccination. After it, the child's body may not give the reaction that is expected.
• There is no information that the result can be affected by exposure to water at the injection site, but doctors still do not recommend wetting it until the final response of the body is obtained.

There is a reverse situation when the patient is sick with tuberculosis, and Diaskintest did not give a positive result. The reason for this may be:

• Healed disease.
• The presence of an inactive form of the disease.
• Finding tuberculosis in the final stage.
• A negative assessment of the results in children can be noted if tuberculosis is severe and gives immunopathological disorders.

The final assessment should be made only by a doctor, if the situation requires, then an additional examination is prescribed and after two months another test for tuberculosis.

What to do if the result is different from the norm?

The norm in children and adults is the almost complete absence of marks at the injection site after three days. If the test turned out to be positive, then tears and panic will not affect the result in any way and will not change it. Further actions should be as follows:

1. Adults must make a fluorography without fail, and children are given an x-ray of the lungs.
2. Babies may be prescribed an ultrasound and a tomogram of the lungs.
3. Pass a standard set of tests.
4. Visit a phthisiatrician, remembering to take all the test results with you.
5. The doctor may prescribe a second test after a while if all other tests are good.
6. When confirming the diagnosis, it is necessary to prepare for the passage of therapy. Parents should tune in to the treatment of the child, which will be long and difficult.

Parents are responsible for the conscientious use of prescribed drugs. Reception should be carried out strictly according to the scheme prescribed by the doctor.

If there are some doubts about the competence of the doctor who analyzed the body's reaction to Diaskintest, then PCR diagnostics can be performed. At the moment, this is the most accurate diagnosis of pathology, because it recognizes the slightest changes at the gene level, which are provoked by the causative agent of tuberculosis.

Diaskin test is a subcutaneous test for the active form of tuberculosis, designed to detect the presence of initial stages diseases or to confirm the preliminary results of fluorography. Diaskintest vaccine is a liquid containing protein allergens, which are a marker of the immune system for killer cells that destroy foreign microorganisms in the human body. A local small allergic reaction of the body to the injected drug or the absence of it is a criterion for evaluating the result. Anyone can evaluate the result of the analysis without a doctor, but for this you need to know what a normal diaskintest should be.

What reaction to diaskintest should be normal?

The results of the norm in a child and in an adult, indicating health, is the complete absence of any manifestations in the area of ​​​​the test with a permissible deviation in the size of the pulp up to four millimeters, and then such a reaction is already considered controversial.

What a normal diaskintest should look like: smooth skin without changes with a possible injection mark or a small residual effect from a bruise in case of a needle accidentally hitting a small blood vein during the test. Slight redness without pulp formation or pulp up to four millimeters in diameter is acceptable. The edges of the pulp and redness should be even.

Also the reaction of diaskintest is the norm. side effects in the form of slight weakness, malaise and fever, not reaching thirty-nine degrees. Redness of the skin that goes beyond the pulp or is present without it is also the norm.

What does a positive result look like?

A positive result is assessed directly by the pulp, and not by redness of the skin, which is only a direct allergy to a foreign protein, and not to an antigen to tuberculosis.

For a pulp of less than four millimeters, there is no single solution. On the one hand, this shows the presence of a pathogen, and on the other, a very, very weak infection that has just been received, which can be ignored or dealt with by strengthening the immune system. Most often, such a small size of the reaction to diaskintest is the norm.

1. If the size of the pulp or button is in the range of five to nine millimeters, then such infection is considered obvious, but weak.
2. 10-14 millimeters is an average positive result, when a person is already definitely infected, but not yet too sick.
3. A severe infection is considered a pulp fifteen to sixteen millimeters in size.
4. A size greater than 16 millimeters in children and 21 mm in adults indicates an extremely severe infection and possibly palpable tissue damage.

Atypical reaction to diaskintest

Diaskintest norm in children and diaskintest norm in adults absolutely coincide, because neither height, nor weight, nor age affects the manifestation of the result, but only the state of the human immune system. An atypical reaction to diaskintest is extremely rare: with the peculiarities of the individual reaction of the body to a foreign protein or if the rules for setting the test and behavior while waiting for the result are not followed.

Who should not install diaskintest:

1. People with infectious diseases or inflammatory processes.
2. With an allergy to Diaskintest or an exacerbation of an allergic reaction to something else.
3. Those who are in the acute phase somatic diseases.
4. A certain list of diseases is a contraindication: hepatitis, pancreatitis, etc.
5. And it also makes no sense to test people with impaired immunity, since it will obviously show a negative result, which may be a lie.

In order for the Diaskintest tuberculosis test to be the norm, a certain number of rules must be observed:

1. Firstly, you can not scratch or cover the injection site with a woolen cloth, as well as irritate in any way.
2. Irritation on the hand can either strengthen the pulp or prevent it from forming.

Secondly, you can not bathe, expose the injection site to the sun and sweat, as sweat corrodes the site of pulp formation.

3. Thirdly, you should wash yourself in advance before vaccination and do not wash the sample site for the entire period from staging to diagnosis. Water by itself has no effect on the sample, but detergents, natural salts or sweat contained in it can increase an allergic reaction or lead to hypersensitivity.

Hyperergia is an atypical local allergic reaction of the body to the foreign protein itself and can result in severe redness and spreading of the spot on the arm, blistering of the urticaria, many spots on the arm and any other skin reactions in the injection area. In case of hyperrergy, the subject is retested in a different way if it is impossible for him to accurately consider the result. If it is clear, then the analysis is counted.

Rare general allergic reactions are also possible, when the subject has any allergy symptoms of varying severity.

Rarely, an atypical reaction can be a jump in temperature up to 39 degrees. In this case, it is urgent to call an ambulance, as with very acute allergies and anaphylactic symptoms.

With a minor tolerable allergic reaction without massive symptoms, it is not recommended to take antihistamines, as they will knock the result in the direction of negative. If the allergy is average with massive skin rashes or vomiting has opened, you must take the medicine and consult a doctor.

The drug Diaskintest is positioned as a modernized analogue of the sample. Its purpose is to detect tuberculosis infection in a child. And although the composition is pharmacological agent indeed can be considered more effective, the evaluation of the results of Diaskintest is still carried out using a conventional ruler.

Diaskintest - how to evaluate the result?

The evaluation of the results of Diaskintest in children is carried out 72 hours after the injection. The drug contains recombinant tuberculosis allergen, diluted according to the standard scheme. Getting under the skin of a child, it interacts with internal fluids. As a result, it becomes possible to obtain a cellular immune response to the antigens specific for Mycobacterium tuberculosis, which are contained in the preparation. This happens through the appearance of a delayed-type skin reaction. Most often, Diaskintest is prescribed after a conditionally positive Mantoux result, or in other situations that make a child suspect tuberculosis:

• to identify and differentiate the type of tuberculosis;
• to evaluate the results of anti-tuberculosis therapy;
• if it is impossible to conduct a tuberculin test.

1. The child is not sick infectious diseases(excluding tuberculosis).
2. Vaccination was carried out intradermally according to all the rules. A qualified medical worker used a special syringe, took 2 doses of the drug, one of which was released into a cotton ball and only the second was introduced to the child. The injection site was chosen correctly - it should be the outer side of the forearm, approximately in the middle.
3. The child does not have somatic diseases in the acute phase and epilepsy.

Analyzing test data

Immediately after the vaccination, the child may experience redness, swelling and other skin reactions, but these should be considered allergic. Usually, all visible consequences of the test disappear within a day, a maximum of two. Sometimes a bruise appears after Diaskintest, this should not affect the results. It is possible to analyze the reaction of the child's body to the introduction of a tuberculosis test only on the third day.

A negative result of Diaskintest indicates that the child is not sick, or the disease is at the final stage of cure. Outwardly, it will look like the absence of redness and papules at the injection site. A slight redness, no more than 2 mm in diameter, also suggests a negative test result.

The result of Diaskintest is doubtful if a red spot of more than 2 mm appears at the injection site, or a papule with an infiltrate. This reaction is the reason for additional diagnostic procedures- X-ray, blood test, ultrasound examination and the like.

If the assessment of the results of Diaskintest gave a positive result, this will manifest itself in this way:

Without the formation of a papule, compaction, or infiltrate, the result cannot be considered positive, it is classified as doubtful and the child is sent to clarify the diagnosis.

When conducting a diaskintest, the results are evaluated in a matter of days, which is an important factor during the diagnosis of tuberculosis, especially if a test is necessary for a child or people with low immunity.

Tuberculosis is a disease that spreads rapidly in crowded environments. In addition, you can become infected with Koch's wand at the slightest, unintentional contact with the carrier of the disease.

What is the result of diaskintest? Diaskintest - diagnostic measure, which successfully replaces the Mantoux test during the analysis for the presence of tuberculosis infection. Due to the low error rate, the tuberculosis test is increasingly being used in the detection of Koch's bacillus by detecting the patient's immune response.

Contrary to popular belief, testing is not a vaccination or vaccine, which makes the procedure as safe as possible for both children and adults.

The main facts for the diagnosis are:

• 90% of the world's population are carriers of the causative agent of the disease - Koch's sticks;
• 1% of the infected population is at risk of developing the disease with a decrease in immune protection;
• tuberculosis is a disease, the first stages of which pass without the manifestation of specific signs.

The treatment of tuberculosis is a long and exhausting process, in addition, an infected person, not wanting it, poses a great threat to the life and health of family members. The longer the disease will develop without proper care, the higher the likelihood of infection of relatives. Children under the age of fourteen, people with weak immunity and pregnant women are at greater risk of the disease.

How Diaskintest is made

The Mantoux test and Diaskintest have a similar diagnostic principle:

1. The procedure is performed subcutaneously.
2. A solution with allergens (proteins to detect the reaction of the body, if the substance is familiar to the immune system, it means that tuberculosis agents are already present in the body) is injected into the forearm area.
3. The evaluation of the results of the diaskintest is carried out on the third day using a transparent measuring ruler.

Testing is carried out on the territory of private and municipal medical institutions as well as in schools and preschools.

In order for a person to be prescribed to undergo a diaskintest for tuberculosis, there are certain reasons:

The tuberculin test diaskintest is considered one of the most modern analogues test for tuberculosis, in addition, the reliability of its result is much higher than that of the Mantoux test.

According to modern law Russian Federation, a person may refuse to vaccinate, inoculate or postpone their conduct for one reason or another. The same applies to the refusal to hold an event that a parent can arrange in relation to his child.

It is also worth noting that in order to conduct a Mantoux test, diaskintest or other procedures in relation to a child, written permission from a parent or official guardian is required. Refusal to vaccinate means that the person assumes all possible consequences solutions.

To write permission or refusal to vaccinate, you must fill out the forms and certificates received from the teacher, and the application can also be issued in free form.

The application must contain:

For each medical event held in educational institution, a separate form is required (it is advisable to fill out two copies so that one of them remains with the parent). Without consent to conduct a diaskintest, diagnostics are prohibited.

However, after writing a refusal to test for tuberculosis, it can provoke some difficulties:

Before choosing a diaskintest tuberculosis test or refusing to conduct it, it is necessary to weigh the consequences and evaluate the contraindications to the test. If a child or an adult has serious reasons associated with contraindications, after consultation with a TB doctor, you can choose an analysis option with fewer side effects for a particular disease.

How is the Diaskintest result checked?

Preparation for analysis includes the definition of contraindications. If they have been identified, it is recommended to replace Diaskintest with an analogue.

The result is evaluated seventy-two hours after the injection, and may be:

1. Negative reaction.
2. False positive or doubtful.
3. Positive.

Features of the test, such as the introduction of antigens that differ from those used during BCG, increase the reliability of testing and reduce the risk of a false positive reaction. This is a significant advantage over the previous analogue - the Mantoux test.

Diaskintest negative or "normal" means that there are no pathogenic agents of the disease in the patient's body and the immune system is unfamiliar with tuberculosis.

The transcript of the results shows:

• visible injection mark;
• a small bruise up to two millimeters in diameter;
• compaction under the skin, not exceeding one centimeter.

After testing, slight redness should be present. A test without manifestations of any reaction before and after the test, as in the case of the Mantoux test, is invalid.

False positive result

Signs of a false positive diaskintest:

• redness of more than four millimeters;
• in the event of an allergic reaction to the composition of the drug.

After the manifestation of such symptoms, a re-analysis is prescribed after a period of two months, it is also possible to prescribe other diagnostic methods.

In addition to the analysis for the presence, after the diaskintest, the evaluation of the results is determined by the number of Koch's sticks.

The size of the swelling around the injection site symbolizes the development of the disease and the number of tuberculosis agents in the human body:

1. Swelling up to five millimeters in diameter is a weak amount.
2. Swelling from five to nine millimeters is a moderate or average amount.
3. More than ten millimeters is a pronounced amount.

The more inflammation around the injection site, the more tuberculosis agents are in the body.

How are outcomes assessed in a child? The size of a positive reaction in a child should be assessed by a doctor, since the manifestation in children different ages are different.

In the case of a positive reaction to tuberculosis, it is necessary to conduct a complete examination as soon as possible and analyze the localization of the disease in order to prescribe an accurate treatment for the disease.

Benefits and comparison with other tests

Diaskintest is a relatively new and rapidly expanding test that has won the trust of patients due to the formula and the objectivity of the result.

The main advantages of diagnostics:

• testing using this method allows more accurate identification of patients with tuberculosis;
• refutes the false positive reaction of the Mantoux test during the passage of BCG vaccination;
• it is highly sensitive to tuberculosis agents, which makes it possible to identify not only active, but also Koch's bacillus that has just begun its development in the body;
• allows you to accurately determine the absence of a pathogen in people who have completed a full course of anti-TB therapy.

Like analogues, diaskintest does not provide information about the stage and localization of tuberculosis, therefore, after a positive or doubtful reaction, the patient should immediately contact a phthisiatrician for a more accurate examination and identification of foci of inflammation.

Like other drugs, diaskintest has contraindications, in the presence of which it is necessary to abandon the procedure or find a suitable analogue of diagnostics.

Contraindications:

1. The presence of bacterial or viral diseases in active form.
2. If the patient has severe skin disorders, dermatitis.
3. Diagnosed epilepsy.
4. During an exacerbation of an allergic reaction or in the presence of an allergy to the components of the drug.
5. Conducting any vaccination less than a month before diagnosis.
6. During exacerbations of diseases of the internal systems of the body.

Contraindications have a negative impact on the human body and reduce the reliability of the diagnosis.

Side effects:

These side effects are included in the list of natural manifestations after diaskintest. However, if their manifestation is too strong or additional side effects are observed, it is necessary to consult a doctor.

Diagnosis does not carry the risk of contracting tuberculosis, since the drug does not contain active mycobacteria of the disease.

Laboratory diagnosis of tuberculosis

In addition to the Mantoux test and diaskintest, more accurate methods are used for the analysis of tuberculosis, which are used in laboratory conditions.

These include:

1. General blood analysis.

PCR is considered to be the most accurate among all those listed because of the diagnostic method and the ability to diagnose all body fluids, revealing not only the development of the disease, but also a predisposition to the development of the disease. Thus, the diagnosis of chlamydia and other bacterial diseases is carried out.

So, sexually transmitted tuberculosis during a strong decrease in immune defense (infection occurs as a secondary infection during pulmonary tuberculosis or transmitted by contact), develops on the soil high level phosphate in the urine.

Features of phosphates in the urine during pregnancy

Pregnant women are at particular risk in relation to tuberculosis, so compliance with all prescribed procedures and studies is vital for both the woman and the life of the unborn baby.

Symptoms:

• urine becomes cloudy, it precipitates;
• renal colic;
• pain and urinary incontinence.

Violation of internal processes in the body often leads to the development of various pathologies.

If the protein in the urine of a child is increased, then the reasons for this are due to the following diseases:

The protein excreted along with urine symbolizes the development of diseases, including tuberculosis.

However, during the collection of material for analysis in children early age problems may arise.

How to collect urine from a baby girl:

• using a special urinal;
• clean polyethylene oilcloth or bag;
• glass or plastic jar.

For boys, the method of collecting urine is similar.

Also during the procedure it is worth adhering to the general rules:

After the diagnosis, the norm and other types of reactions that need to be carried out to study the child's condition are revealed.

It is noted that when taking ELISA and PCR tests, the test result may differ.

This usually happens for a number of reasons:

Laboratory studies have their pros and cons and often complement each other's shortcomings, so TB doctors prescribe a comprehensive study using several methods.

In addition, people work in laboratories, which means that there is always the possibility of introducing a “human factor”, so you should not calm down or be upset after receiving one analysis. For a complete diagnosis, it is recommended to go through all the prescribed procedures.

Tuberculosis is a disease that is transmitted not only from one person to another, but also capable of infecting domestic animals, including cattle. To preserve the health of pets (as well as to avoid infection with infections dangerous to humans), it is customary to vaccinate animals, just like people. In addition to BCG, other drugs are also used for animals (Wakderm vaccine). Some of the activities need to be carried out in veterinary clinics, others can be done independently by studying the application and dosages. medicinal product.

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• Congratulations! The chances of you being over TB are close to zero.

  But do not forget to also monitor your body and regularly undergo medical examinations and you are not afraid of any disease!
  We also recommend that you read the article on.

• There is reason to think.

  It’s impossible to say with accuracy that you have tuberculosis, but there is such a possibility, if it’s not, then something is clearly wrong with your health. We recommend that you go immediately medical examination. We also recommend that you read the article on.

• Contact a specialist immediately!

  The likelihood that you are affected is very high, but remote diagnosis is not possible. You should immediately contact a qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on.

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Task 1 of 17

1 .

Is your lifestyle associated with severe physical activity?

1. Task 2 of 17

   2 .

   How often do you have a TB test (eg mantoux)?

2. Task 3 of 17

   3 .

   Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

3. Task 4 of 17

   4 .

   Are you taking care of your immunity?

4. Task 5 of 17

   5 .

   Have any of your relatives or family members suffered from tuberculosis?

5. Task 6 of 17

   6 .

   Do you live or work in an unfavorable environment(gas, smoke, chemical emissions from enterprises)?

6. Task 7 of 17

   7 .

   How often are you in a damp or dusty environment with mold?

7. Task 8 of 17

   8 .

   How old are you?

8. Task 9 of 17