I have the priviledge to perform the Mantoux’s test on a patient fellow medical student today! Yay!

Mantoux’s test is an intradermal injection of tuberculin, a clear solution containing protein derivatives of the bacteria causing tuberculosis (TB)or commonly known as Mycobacterium tuberculosis. It is done on patients suspected to have contracted TB. However, it is not a diagnostic test as it only confirms the presence of immunity against TB bacteria. The patient may find an enlarged, slightly raised or even reddened patch at the site of injection. Fear not, as this is the common skin reaction to Mantoux’s test. The patient has to return three days later to have the skin induration measured by a doctor or an experienced nurse. If the diameter measures more than 10mm it means that the person has immunity against M. tuberculosis. The activated defense system against TB may be due to a past infection, an on-going infection or immunity as a result of vaccination against TB i.e. the BCG (Bacille Calmette -Guerin) injection we receive at birth. A induration size of 15mm or more is likely to suggest an on-going infection with an active defense system battling against the bacteria in the body. Nevertheless, it is important to bear in mind that TB is not diagnosed via Mantoux’s test but by sputum examination for acid-fast bacilli (AFB). Usually there are also positive lung markings in chest X-ray.

I injected my coursemate with the tuberculin and vice versa. It hurts just a little. I think a red-ant bite is more painful than a needle prick. It was pretty easy but the nurse commented that both of us had injected a little too deep into the skin. This might affect the readings. We weren’t able to produce the nice, raised, circular formation of orange-peel appearance on the injection area once the tuberculin was pushed in. Anyway, I’m looking forward to measure my induration (if there’s any at all) three days later. Hah…

This afternoon I shall get my hands on the kids :p If I’m lucky I might get a chance to immunise babies or toddlers! Too bad the diabetic clinic was not opened today or I’d get to self-inject insulin on my own abdomen, as what insulin-dependent diabetic patients are supposed to do. Of course, the insulin will be substituted with normal saline instead to prevent inducing hypoglycaemia (a state of low blood sugar level) in me.

It’s not that I love getting pricked. But I thought it’ll be interesting and meaningful to really put myself into patients’ shoes and feel the pain. Not a sickening hobby… just for experience’s sake