Tuberculin test measurement: variability due to the time of reading.

STUDY OBJECTIVES

It is recommended that the PPD Mantoux tuberculin test be read at 48 or 72 h. We have compared the measurements at these time points.

DESIGN

A 10-tuberculin unit (TU) PPD Mantoux test was administered to 116 healthy subjects (76.7% with bacillus Calmette-Guérin scars).

PARTICIPANTS

One hundred sixteen healthy adult volunteers were recruited (health service employees, 29 volunteers; general public, 87 volunteers).

RESULTS

The measurements made at 72 h were significantly higher than those made at 48 h (median, 9.4 vs 4.95 mm, respectively; p = 0.017). In those subjects with induration at either or both time points (n = 69), the readings taken at 72 h were on average 1.7 mm (95% confidence interval, 0.4 to 3.0 mm) larger than those at 48 h. Using an induration of > 15 mm diameter to define a positive result, there were more positive test results at 72 h (36) compared to 48 h (28), with the results from 10 subjects (8.5%) changing because of the time of measurement.

CONCLUSIONS

This study demonstrates that, in adults, the size of the 10-TU Mantoux reaction is significantly larger at 72 h compared to the reaction at 48 h. In clinical practice, tuberculin tests should be read at 72 h as negative tests at 48 h may be false results.