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  • Title: Management of a child with a positive tuberculin test.
    Author: Chaulet P, Ait Khaled N.
    Journal: Child Trop; 1992; (196-197):77. PubMed ID: 12345146.
    Abstract:
    Management of a positive tuberculin test in a child from a country where BCG vaccination is common in infancy may signify a natural tuberculosis (TB) infection or reinfection or mere BCG vaccination. ALthough there are some new studies claiming that the size of induration can tell recent infection in a BCG-vaccination child, this is not proven. The first step is to determine either from history or examination for scars whether the child has had BCG. Next the child is examined for signs of TB, and family contacts with TB are ascertained. If either is positive, a chest x-ray is needed. If the child had had BCG and is healthy, no prophylaxis is done, unless he has been in contact with a person with active TB. IF the child has not been vaccinated with BCG, any positive PPD test indicates primary infection in children under 3, and probable recent infection in children under 5. These children are given prophylaxis. In children aged 5-14 without documented negative PPD test within 2 years, prophylaxis is not given. But if such a child can show negative tests in the last 2 years, new infection is assumed and prophylaxis is given. Always trace the source of infection when a child with a positive PPD is discovered.
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