* It is very unlikely that a side effect to the test will occur. If such an event does happen, the most common reaction is pain or redness at the test site. In very rare cases, a person who is hypersensitive to the solution could have a severe allergic reaction near the injection site. Such rare reactions may include blistering or a skin wound.

2025年1月31日 · In this test, a standardized solution made with purified protein derivative (PPD), which is derived from tuberculin, is injected under the skin. Typically, PPD produces a T-cell mediated delayed-type hypersensitivity reaction if the person has been infected with TB bacteria.

ONE WEEK AFTER STEP ONE READ DATE: STEP TWO Mantoux Tuberculin Skin Test 0.1 ml intradermal injection

TUBERCULOSIS/MANTOUX SKIN TESTING FORM SECTION I: INFORMATION/CONSENT Mycobacterium tuberculosis (TB) is a disease which is carried through the air in small particles when people who have active TB cough, sneeze, speak, or sing.

I hereby agree to have a PPD tuberculin skin test. To my knowledge, I have not previously had a positive skin test for TB, nor have I had a chest x-ray that was positive for TB. I understand that there may be a reaction to this test in the form of small skin eruption at the site of the injection.

To determine if a skin test should be administered, conduct a risk assessment for each patient that takes into consideration recent exposure to TB disease, clinical conditions that increase the risk for TB disease if infected, and the program’s capacity to …

The most commonly used skin test to check for TB is the PPD \u2014 purified protein derivative. If you have a positive PPD, it means you have been exposed to a person who has tuberculosis and you are now infected with the bacteria (mycobacterium tuberculosis) that causes the disease.

Submit documentation of previous positive PPD or have provider sign below. Date of positive PPD: Results in mm: Provider Signature. Submit a copy of a chest x-ray report taken within the last year. Date of X-ray:

Interpretation of test: 48-72 hours after administration Positive: palpable induration of 10mm or more 5mm if had close contact with individuals with tuberculosis Doubtful Reaction: 5-9 mm, retest second site with 5TU Negative Reaction: induration …

Test Read (48-72 hours later) By: _______________________________Date: ______/______/______