2 step PPD SKIN TEST 

The Mantoux tuberculin skin test (TST) is the standard method of determining whether a person is infected with Mycobacterium tuberculosis. Reliable administration and reading of the TST requires standardization of procedures, training, supervision, and practice.

How i s the TST Administered?

The TST is performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The injection should be made with a tuberculin syringe, with the needle bevel facing upward. The TST is an intradermal injection. When placed correctly, the injection should produce a pale elevation of the skin (a wheal) 6 to 10 mm in diameter.

How i s the TST Read?

The skin test reaction should be read between 48 and 72 hours after administration.

A positive result will form a red and swollen circle at the site of the injection. The size (diameter) of the swollen raised circle determines whether exposure to TB has occurred. The size that is considered positive varies with the health status and age of the individual. Even when infected, children, the elderly, and people who are severely immune compromised (such as those with AIDS) may have smaller, delayed, or even negative reactions to the TST.

 wo-step testing with the Mantoux tuberculin skin test (TST) should be used for baseline or initial testing. Some people with latent TB infection have a negative reaction when tested years after being infected. The first TST may stimulate or boost a reaction. Positive reactions to subsequent TSTs could be misinterpreted as a recent infection.

What is a 2 step TB Test 

Step 1

Administer first TST following proper protocol
Review result
Positive — consider TB infected, no second TST needed; evaluate for TB disease.
Negative — a second TST is needed. Retest in 1–3 weeks after first TST result is read.
Document result

Step 2

Administer second TST 1-3 weeks after first test
Review results
Positive — consider TB infected and evaluate for TB disease.
Negative — consider person not infected.
Document result

Is there anything else I should know?

***ONLY OCCUPATIONAL CLINIC LOCATIONS PROVIDE TB SKIN TEST*** 

TB Skin Test Clinic Locations