Mantoux Test

Tuberculin Test/Mantoux Test

	Tuberculin Test / Mantoux Test - Tuberculosis is diagnosed in laboratory by tuberculin test. The old method, originally described by Koch, for preparation of tuberculin is old tuberculin (OT). Here tuberculin is prepared by autoclaving or boiling a culture of tubercle bacilli, concentrating it tenfold on a steam bath, filtering off the debris and adding glycerol as preservative. Stock solution retains full potency for years when stored at 5°C.
A refined method of tuberculin preparation is purified protein derivative (PPD). It is prepared by precipitation several times with 50% saturated ammonium sulphate. The product is mostly a mixture of small proteins.Now tuberculin hypersensitivity is tested by intradermal injection of 0.1 ml of an appropriate dilution of standardised PPD into the most superficial layers of the skin of the forearm. This is known as Mantoux test. The average diameter of induration (and not simply erythema) at the injected site is measured at 48 hr, and reactions less than 10 mm in diam. are recorded as doubtful. Intense reactions can cause necrosis and scarring.There are other mycobacteria which are non tuberculous and are pathogenic in human causing other diseases. These are Mycobacterium scrofu/aceum, M. kansassii, M. ulcerans, M.marinum and M. xenopi.
Mycobacterium leprae, (Hansen's bacillus), cause of leprosy, grows profusely in lesions, and could not be cultivated in test tubes. In 1960 shepard discovered that the bacilli could be slowly propagated in foot pads of mice in cool environment. Recently nine banded armadillo is used for skin test. Antigen,Lepromin,as developed by Mitsuda in 1919, is obtained by boiling human lepromatous tissue rich in bacilli. This material lepromin, is then standardised to contain 160x 10 ⁶ acid fast bacilli/ml

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