Patient Tuberculosis Risk Assessment Page 4
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4INTERPRETING MANTOUX TUBERCULIN TESTS
Important Skin Testing information:
The Mantoux skin test should be read 48 to 72 hours after the injection, and the diameter of induration (not erythema) should be
measured transversely to the long axis of the forearm and recorded in millimeters.
For the following persons who are at highest risk of developing active tuberculosis disease if they are infected, tuberculin
skin tests are considered positive at 5mm of induration or larger:
•
Recent contacts of TB case patients
•
Persons with fibrotic changes on chest radiograph consistent with prior TB
•
Patients with organ transplants and other immunosuppressed patients (eg. taking the equivalent of >15 mg/day of
prednisone for 1 month or longer, or taking tumor necrosis factor inhibitors)
•
Human Immunodeficiency Virus (HIV/AIDS) infected persons
For the following persons with other known high-risk medical conditions or population risks for recent infection,
tuberculin skin tests are positive at 10mm of induration or larger:
•
Foreign-born persons, including children, from areas that have a high TB incidence or prevalence. (e.g., Latin
America and the Caribbean, Africa, Asia, Eastern Europe, and Russia, South America)*
•
Illicit drug use
•
Residents and employees of the following high-risk congregate settings:
o Correctional institutions
o Long-term care facilities
o Mental health institutions
o Hospitals and other health care facilities
o Residential facilities for patients with acquired immunodeficiency syndrome (AIDS)
o Homeless shelters
•
Mycobacteriology laboratory personnel
•
Persons with the following clinical conditions that place them at high risk:
o Silicosis
o Diabetes mellitus
o Chronic renal failure/end-stage renal disease
o Hematologic/reticuloendothelial disease
o Cancer of head, neck, or lung
o Low body weight (10% or more below ideal body weight)
o Intestinal bypass or gastrectomy
o Chronic malabsorption syndromes
o Organ transplant
•
Children < 4 years of age (unless the child falls under another category due to condition or exposure)
•
Infants, children, and adolescents frequently exposed to adults at high risk for TB infection
•
Travelers who have reported history of prolonged exposure or extended stay in endemic country (listed above)
For persons at low risk for TB, for whom tuberculin testing is not generally indicated, tuberculin skin tests are positive at
15mm of induration or larger:
•
Persons with no known risk factors for TB.
*Additional instructions/recommendations may apply to individuals seeking care through a Civil Surgeon. Please reference
recommendations:
Reference: Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection, CDC, MMWR, Vol. 49, RR-6, June 9, 2000.
CDC fact sheet “Targeted Tuberculin Testing and Interpreting Tuberculin skin Test Results, April 2005.”
WDH TB Program • December 2016
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