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The medical history includes obtaining the symptoms of pulmonary TB: productive, prolonged cough of three or more weeks, chest pain, and hemoptysis.Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to purulent. [1]
Previously, Quantiferon-TB Gold was able to be used in any situation in which the Tuberculin Skin Test (TST) was used, without preference. The 2010 guidelines establish a new benchmark because they recommend IGRAs as the preferred TB testing method in many patients, including those who are BCG vaccinated or are unlikely to return for TST reading.
The BCG vaccine prevents severe forms of TB in children, such as TB meningitis. It would be expected that BCG would have the same effect in preventing severe forms of TB in children, even if they were exposed to XDR-TB. The vaccine has shown to be less effective at preventing the most common strains of TB and in blocking TB in adults. [6]
Most infections show no symptoms, in which case it is known as latent tuberculosis. [1] Around 10% of latent infections progress to active disease that, if left untreated, kill about half of those affected. [1] Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss. [1]
Until 2005, the test was used in the United Kingdom to determine if the BCG vaccine was needed; the Mantoux test is now used instead. The Heaf test was preferred in the UK, because it was thought to be easier to interpret, with less variability between observers, and less training was required to administer and read the test.
Through the failures and successes of tuberculin, more than ever before is known about the causes and symptoms of tuberculosis and the measures to prevent it. In addition, the discovery of the tuberculin skin test paved the way to the world's understanding of many other mycobacterial infections as well as certain fungal infections. [ 13 ]
The introduction of the Bacille Calmette-Guérin (BCG) vaccine in 1921 and the development of antibiotics helped curb the mortality rate even further. Today TB is curable and preventable.
The US recommends that tuberculin skin testing is not contraindicated for BCG-vaccinated persons, and prior BCG vaccination should not influence the interpretation of the test. The UK recommends that interferon-γ testing should be used to help interpret positive Mantoux tests of over 5 mm, [ 20 ] and repeated tuberculin skin testing must not ...