Tine test | |
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Purpose | diagnosis for tuberculosis |
The tine test is a multiple-puncture tuberculin skin test used to aid in the medical diagnosis of tuberculosis (TB). The tine test is similar to the Heaf test, although the Mantoux test is usually used instead. There are various forms of the tine tests which usually fall into two categories: the old tine test (OT) and the purified protein derivative (PPD) tine test. Common brand names of the test include Aplisol, Aplitest, Tuberculin PPD TINE TEST, and Tubersol. [1]
This test uses a small "button" that has four to six short needles coated with TB antigens (tuberculin), either an old tuberculin or a PPD-tuberculin. The needles are pressed into the skin (usually on the inner side of the forearm), forcing the antigens into the skin. The test is then read 48 to 72 hours later by measuring the size of the largest papule or induration. Indications are usually classified as positive, negative, or doubtful. [2]
Because it is not possible to control precisely the amount of tuberculin used in the tine test, a positive test should be verified using the Mantoux test. [3]
Tuberculin is a glycerol extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a precipitate of non-species-specific molecules obtained from filtrates of sterilized, concentrated cultures. It was first described by Robert Koch in 1890 and then Giovanni Petragnani.[ citation needed ] A batch of PPD created in 1939 serves as the US and international standard, called PPD-S. [4] PPD-S concentration is not standardized for multiple-puncture techniques, and should be designed for the specific multiple-puncture system. [5]
The American Thoracic Society or Centers for Disease Control and Prevention (CDC) do not recommend the tine test, since the amount of tuberculin that enters the skin cannot be measured. [6] For this reason, the tine test is often considered to be less reliable.[ citation needed ]
Contrary to this, however, studies have shown that the tine test can give results that correlate well to the Mantoux test. [7] [8] If a minor reaction is considered doubtful, the OT test is less accurate and may fail to detect TB, producing a false negative. [2] If all doubtful indications are instead classified as positive, there is no significant difference between the OT test, the PPD tine test, or the Mantoux test. [3]
Furthermore, the tine test is faster and easier to administer than the Mantoux test and has been recommended for screening children. [9] [10]
The Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB). It is named after its inventors Albert Calmette and Camille Guérin. In countries where tuberculosis or leprosy is common, one dose is recommended in healthy babies as soon after birth as possible. In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated. Adults who do not have tuberculosis and have not been previously immunized, but are frequently exposed, may be immunized, as well. BCG also has some effectiveness against Buruli ulcer infection and other nontuberculous mycobacterial infections. Additionally, it is sometimes used as part of the treatment of bladder cancer.
Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis. Around 10% of latent infections progress to active disease that, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss. Infection of other organs can cause a wide range of symptoms.
The Mantoux test or Mendel–Mantoux test is a tool for screening for tuberculosis (TB) and for tuberculosis diagnosis. 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, a form of tine test, was used until 2005 in the UK, when it was replaced by the Mantoux test. The Mantoux test 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 post-Soviet states, although Soviet mantoux produced many false positives due to children's allergic reaction.
Pott's disease, or Pott disease, named for British surgeon Percivall Pott who first described the symptoms in 1799, is tuberculosis of the spine, usually due to haematogenous spread from other sites, often the lungs. The lower thoracic and upper lumbar vertebrae areas of the spine are most often affected.
Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. Examples of these conditions include meningitis and subarachnoid hemorrhage. It may also be used therapeutically in some conditions. Increased intracranial pressure is a contraindication, due to risk of brain matter being compressed and pushed toward the spine. Sometimes, lumbar puncture cannot be performed safely. It is regarded as a safe procedure, but post-dural-puncture headache is a common side effect if a small atraumatic needle is not used.
The Heaf test, a diagnostic skin test, was long performed to determine whether or not children had been exposed to tuberculosis infection. The test was named after F. R. G. Heaf. Also known as the Sterneedle test, it was administered by a Heaf gun, a spring-loaded instrument with six needles arranged in a circular formation which was inserted in the wrist or shoulder.
Tuberculosis is diagnosed by finding Mycobacterium tuberculosis bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.
This is a list of AIDS-related topics, many of which were originally taken from the public domain U.S. Department of Health Glossary of HIV/AIDS-Related Terms, 4th Edition.
Tuberculin, also known as purified protein derivative, is a combination of proteins that are used in the diagnosis of tuberculosis. This use is referred to as the tuberculin skin test and is recommended only for those at high risk. Reliable administration of the skin test requires large amounts of training, supervision, and practice. Injection is done into the skin. After 48 to 72 hours, if there is more than a five to ten millimeter area of swelling, the test is considered positive.
Miliary tuberculosis is a form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1–5 mm). Its name comes from a distinctive pattern seen on a chest radiograph of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds—thus the term "miliary" tuberculosis. Miliary TB may infect any number of organs, including the lungs, liver, and spleen. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and accounts for up to 20% of all extra-pulmonary tuberculosis cases.
Tuberculosis verrucosa cutis is a rash of small, red papules and nodules in the skin that may appear two to four weeks after inoculation by Mycobacterium tuberculosis in a previously infected and immunocompetent individual.
Florence Barbara Seibert was an American biochemist. She is best known for identifying the active agent in the antigen tuberculin as a protein, and subsequently for isolating a pure form of tuberculin, purified protein derivative (PPD), enabling the development and use of a reliable TB test. Seibert has been inducted into the Florida Women's Hall of Fame and the National Women's Hall of Fame.
Latent tuberculosis (LTB), also called latent tuberculosis infection (LTBI) is when a person is infected with Mycobacterium tuberculosis, but does not have active tuberculosis (TB). Active tuberculosis can be contagious while latent tuberculosis is not, and it is therefore not possible to get TB from someone with latent tuberculosis. The main risk is that approximately 10% of these people will go on to develop active tuberculosis. This is particularly true, and there is added risk, in particular situations such as medication that suppresses the immune system or advancing age.
Tuberculosis (TB) vaccines are vaccinations intended for the prevention of tuberculosis. Immunotherapy as a defence against TB was first proposed in 1890 by Robert Koch. As of 2021, the only effective tuberculosis vaccine in common use is the Bacillus Calmette-Guérin (BCG) vaccine, first used on humans in 1921. It consists of attenuated (weakened) strains of the cattle tuberculosis bacillus. It is recommended for babies in countries where tuberculosis is common.
Interferon-γ release assays (IGRA) are medical tests used in the diagnosis of some infectious diseases, especially tuberculosis. Interferon-γ (IFN-γ) release assays rely on the fact that T-lymphocytes will release IFN-γ when exposed to specific antigens. These tests are mostly developed for the field of tuberculosis diagnosis, but in theory, may be used in the diagnosis of other diseases that rely on cell-mediated immunity, e.g. cytomegalovirus and leishmaniasis and COVID-19. For example, in patients with cutaneous adverse drug reactions, the challenge of peripheral blood lymphocytes with the drug causing the reaction produced a positive test result for half of the drugs tested.
Interferon-gamma release assays (IGRAs) are diagnostic tools for latent tuberculosis infection (LTBI). They are surrogate markers of Mycobacterium tuberculosis infection and indicate a cellular immune response to M. tuberculosis if the latter is present.
T-SPOT.TB is a type of ELISpot assay used for tuberculosis diagnosis, which belongs to the group of interferon gamma release assays. The test is manufactured by Oxford Immunotec in the UK. It is available in most European countries, the United States as well as various other countries. It was developed by researchers at the University of Oxford in England.
ESAT-6 or early secreted antigenic target 6 kDa, is produced by Mycobacterium tuberculosis, it is a secretory protein and potent T cell antigen. It is used in tuberculosis diagnosis by the whole blood interferon γ test QuantiFERON-TB Gold, in conjunction with CFP-10.
The Fernandez reaction is a reaction that occurs to signal a positive result in the lepromin skin test for leprosy. The reaction occurs in the skin at the site of injection if the body possesses antibodies to the Dharmendra antigen, one of the antigens found in Mycobacterium leprae, the bacteria that causes leprosy. The reaction occurs via a delayed-type hypersensitivity mechanism. This reaction occurs within 48 hours of injection of lepromin and is seen in only tuberculoid forms of leprosy. This represents a delayed-type hypersensitivity reaction. In contrast, the Mitsuda reaction occurs 3–4 weeks after injection of lepromin and is only seen in patients with the tuberculoid form of leprosy. In terms of mechanism of action and appearance, the reaction is similar to the tuberculin reaction of a positive Mantoux test for tuberculosis.
The antibodies from lymphocyte secretions (ALS) assay is an immunological assay to detect active diseases like tuberculosis, cholera, typhoid etc. Recently, ALS assay nods the scientific community as it is rapidly used for diagnosis of Tuberculosis. The principle is based on the secretion of antibody from in vivo activated plasma B cells found in blood circulation for a short period of time in response to TB-antigens during active TB infection rather than latent TB infection.
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