Tuberculin Skin Test (PPD)

Tuberculin Skin Test (PPD)

Important in the diagnosis of new cases of tuberculosis disease and the differential diagnosis and a specific test. Furthermore, prophylactic treatment with isoniazid help decide. The most widely used are two types of tuberculin: 1 Tuberculin OT (old tuberculin = old tuberculin) 2 PPD (purified protein derivative = pure protein derivative). PPD is prepared in a standard way for people to another is preferred. The most widely used method for tuberculin test intradermik injection. This is called the Mantoux test. Mantoux test is essential for the forearm flexor surface of the skin after cleaning 0.1 to 5 units of PPD or OT intradermik is injected.

Interpretation of Mantoux tuberculin test intradermik 48 or 72 hours after injection of 10 mm or more induration (papules), a positive reaction.

Tuberculin sensitivity of becoming infected with M.tüberkülosis 2-8 weeks (average 6 weeks) and then develops. A positive tuberculin test, that person is infected with Mycobacterium tuberculosis, husule indicates that the sensitivity, but it does not mean disease. Husule the sensitivity is usually permanent. Heavy seyderen diseases, measles, or smallpox vaccine flowers, high fever, sarcoidosis, advanced tuberculosis, leukemia, lymphoma, Hodgkin's, severe malnutrition, cachexia, advanced age, immunosuppressive drugs such as corticosteroids, uncontrolled diabetes, and alcoholism with the tuberculin sensitivity is reduced or temporarily lost. Tuberculosis infection is the tuberculin skin test may be negative or passed, though, it is called a false negative tuberculin test. Technical error, measurement and interpretation errors related. The tests may be negative bacilli taken up to 2-8 weeks, enough time to geçmemiştir sensitivity. Tuberculin skin test is positive after a while edilince again.

BCG vaccination in those would be positive tuberculin.

Milyer tuberculosis, meningitis, serious diseases such as tuberculosis and more rarely, may be negative tubercle in tuberculosis pleurisy. Receipt of the required immunosuppression therapy to control tuberculosis infection positive tuberculin is recovered.

Other laboratory examination

Many times is normal leukocytes. Some 10,000 to 15,000 patients to increase. Less than 10% monocytes. Normocytic anemia, reduction of serum albumin and serum globulin are increased. Increased sedimentation rate. Hematuria, or urine of renal tuberculosis may be related to inflammation.

Facilitating factors of tuberculosis disease

These factors examined in 3 main groups: 1 Source of infection. 2 The amount and virulence of bacteria. 3. Infected person's resistance.
The main source of infectious tuberculosis patients balgamıdır source of infection. Coughing, sneezing, talking loudly, singing, droplets of the bacilli in the sputum of tuberculosis infection can be transmitted by inhaled by others. Routinely used by the patients and careful cleaning of goods generally prevents contamination.

The amount of bacteria and the number of bacterial virulence and virulence received more basillerle-infected persons with tuberculosis disease increases the chance.

An infected person's resistance to the age of cases of primary tuberculosis, such as tuberculosis and meningitis milyer rate is more serious types of hematogenous tuberculosis. Menopause and the first three months of pregnancy and after birth andrapoz periods and increases the chance of tuberculosis.

Environmental factors

Toxic factors such as smoking and alcohol consumption increases the incidence of tuberculosis and reduce the chance of treatment. Areas, such as immunosuppressive drugs in patients undergoing long-term corticosteroid therapy increases the possibility of tuberculosis.

Tuberculosis incidence of diseases is high

There is an inverse relationship between diabetes mellitus and tuberculosis.
That is higher than the incidence of diabetes in patients with tuberculosis. And the development of diabetes in patients than tuberculosis rate is monitored. The possibility of not responding to treatment of diabetes mellitus in patients with tuberculosis should be examined carefully. The symptoms of diabetes or a family member with suspected tuberculosis, especially in patients with diabetes, fasting blood sugar should be consulted. Diabetes glucose tolerance test, fasting blood sugar is normal should be investigated. Chest radiographs of patients with diabetes lower lobe-tuberculosis cases of tuberculosis disease is more common in other locations. Therefore, the lower lobes of adult tuberculosis in an individual diagnosed diabetes kuşkulanmalıdır edilince.
High incidence of tuberculosis in patients with silicosis.

Hypothyroidism, measles and whooping cough disease resistance of tuberculosis infection is reduced.
Gastrectomy in cases of eating disorders is more associated with tuberculosis insidenisinin. The patients for surgical intervention, especially those with abdominal surgery, the chest radiograph should be drawn before the surgery.

Cancer, Hodgkin's, leukemia and other diseases debilitan increases the incidence of tuberculosis, related to a reduction in resistance to infection.

Increased incidence of tuberculosis in patients undergoing renal transplantation, immunosuppressive therapy, and hospital personnel related to contamination.

Sarcoidosis is a relationship between disease and atypical tuberculosis husule mikobakteriumla sarcoidosis has been suggested to come. This relationship is proven objectively. But more important is that the incidence of tuberculosis in patients with sarcoidosis, an observation. This should consider the possibility of sarcoidosis patients in the prophylactic treatment of tuberculosis and treatment of corticosteroid should be applied.

Higher incidence of tuberculosis in AIDS patients and many times relates to a type of atypical mycobacterium. PPD is often negative in patients with AIDS. Lymphadenopathy in patients with AIDS, tuberculosis, extrapulmonary tuberculosis more frequently being monitored and other tüberkülozlardan Intracavernous less.

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