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Mantoux TB test , fnac test for neck
Nov 18, 2017

Induration 18mm, erythema 19mm, fnac test not taken, example if fnac test is positive what is the actual health issue, could u please tell me and give suggestions

Response from Dr. Young

Hello and thanks for posting.

Tuberculosis (TB) is a common co-infection among people living with HIV, and the leading cause of death for positive people worldwide. In the US, tuberculosis is relatively uncommon.

In the US, screening for TB infection is recommended as part of initial evaluation of people living with HIV. There are two screening tests, the Mantoux skin test (see below) and a blood-based interferon gamma releasing assay (called Quantiferon). In the absence of clinical tuberculosis symptoms, many people should be treated with antibiotics for latent (asymptomatic) infection, as this prevents the later development of clinical disease. Positive people who are close contacts of people with active tuberculosis should also receive treatment for latent infection, regardless of their screening test results.

The Mantoux test looks for evidence of exposure to Mycobacterium tuberculosis (MTB) - the bacteria that causes tuberculosis. The test is performed by placing a small amount of purified protein derivative (called PPD) in the skin (called an intradermal injection)

In people with prior MTB infection, immune responses cause the area to become hardened (indurated). Since it takes a while for the immune system to respond to the inoculation the test should be interpreted after 48 and 72 hours. A test is considered positive in people living with HIV when the indurated area is 5 mm or greater.

In your case, the test is strongly positive. This doesn't distinguish between people with prior MTB exposure (without tuberculosis disease) and those who have active tuberculosis. Only clinical signs/symptoms and other diagnostic tests can tell the difference.

Since you mention a FNA (fine needle aspiration), this suggests that your care providers are concerned about a suspicious lesion in your neck. This could be because of tuberculosis or other process (such as unsuppressed HIV, other infection or cancer). I would defer to your providers as to the importance of doing the FNA at this point in your diagnostic evaluation.

For more information about the Mantoux test, check out this page from the US CDC.

I hope that's helpful. BY


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