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The use of the Intracutaneous Tuberculin Test (" Mantoux
Test ") in Diagnosis.
The use of the " Mantoux " test in diagnosis, especially in
the diagnosis of intrathoracic tuberculosis in childhood, has of late
become more stabilised. In consequence its use as a diagnostic
aid has not been lost sight of in connection with the work of the
Clinic.
Whilst pulmonary tuberculosis of the adult type is rare in
childhood, intrathoracic tuberculosis does occur, and is always a
difficult problem.
This test can undoubtedly be of help.
Speaking generally a negative reaction to the " Mantoux "
test is the rule up to two years of age.
Should the reaction be positive in the first two years of life
it may be assumed that we are dealing with an active case of
tuberculosis.
If, in addition, there is a history of contact with a case of
tuberculosis, the diagnosis is certain.
After the age of two or three years a positive reaction is not
significant, and does not necessarily mean active disease.
At the age of 14 it is generally assumed that the great bulk
of children show a positive reaction. A positive reaction points
to infection, and the degree of reaction is, in the majority of cases,
a measure of the severity of the infection.
A negative reaction in an ailing child, with few exceptions,
may be taken to mean that tuberculosis is not the cause of the
illness.
Hence we see, despite its limitations, the value in diagnosis
of this test, of which we are now making use at the Clinic.
Thoracic Surgery in Diagnosis and Treatment.
Brief reference was made to the increasing value of surgical
methods in diagnosis, and especially as an adjunct to the routine
treatment of pulmonary tuberculosis,