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Q. Why Mantoux test is advised for cough and cold?

Answered by
Dr. Deepak Patel
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Nov 19, 2015 and last reviewed on: Feb 23, 2019

Hi doctor,

My kid is 2.5 years old. She keeps getting cough and cold every month. She is very sensitive to weather change. We consulted a local doctor and he advised for Mantoux test. The report says that the erythema and induration developed around 18x16 mm area after 48 hours. What does it mean? Also, the doctor has given tablet Rifacept Kid-3 for six months. Please explain what is it for?

Dr. Deepak Patel

Child Health Paediatrics
#

Hi,

Welcome to icliniq.com.

Recurrent episodes of cough and cold occur when the child has decreased immunity due to some illness or it could be a symptom of tuberculosis. Mantoux test of more than 10x10 mm is suggestive of tuberculosis. In your child, it is 18x16 mm which is strongly positive.

In tuberculosis, the symptoms are weight loss or poor weight gain, persistent cough and low-grade fever. The confirmation tests are positive Mantoux test, increased ESR level, and x-ray may or may not show patches. Usually, a history of tuberculosis contact is also present.

Going by symptoms in your child, like recurrent cough and cold, weight is around 12 kg which is less for her age with positive Mantoux test is suggestive of tuberculosis.

In tuberculosis, treatment is continued for six months. Initially, a combination of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol is given for two months which is changed to Isoniazid and Rifampicin for four months.

Your doctor has given Rifacept Kid-3 tablet which contains Isoniazid, Rifampicin, and Pyrazinamide but no Ethambutol. In my opinion, Akurit-4 should be started which has Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol, this should be given for two months after which drug should be changed to a combination of Isoniazid and Rifampicin.

You should give the drug of tuberculosis regularly; tuberculosis is a treatable disease so there is no need to panic.



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Hi doctor,

Thank you for your reply. Are there any special measures to be followed? Please give your suggestions for her diet and living environment.

Dr. Deepak Patel

Child Health Paediatrics
#

Hi,

Welcome back to icliniq.com.

You should give her a multivitamin syrup like syrup Bevon 5 ml twice a day till the medicines continue. There should be proper ventilation at home.

Tuberculosis usually spreads from contact with an infected person. Try to find out who has tuberculosis nearby. Get chest x-ray of all family members to know whether they are infected with tuberculosis or not.

For the first five days of starting the treatment, the child can spread tuberculosis, so try to cover her mouth while sneezing. After five days, infection will not spread.


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Hi doctor,

Is there any precaution to be taken for diet? Should we protect her from cold such as bathing and room temperature? She is going playgroup now. Should we stop her from school for some days?

Dr. Deepak Patel

Child Health Paediatrics
#

Hi,

Welcome back to icliniq.com.

First of all, you should keep in mind that tuberculosis is a treatable disease and you should not panic much about it. It is a very common disease which is totally curable.

When we start the treatment of tuberculosis, sometimes the child may have nauseating feeling and due to Rifampicincomponent, the saliva and urine becomereddish-orange. Both are normal and you should not stop the drug due to this.

Isoniazid component can lead to pyridoxine deficiency, so the child must be given multivitamin syrup till the treatment continues. You should treat the child as normal and there is no special diet modification for tuberculosis. You just give her the foods that you were giving her earlier.

You can bath the child as you were bathing her before. Yes, the child should be protected from extreme temperature and proper clothing should be done during winters.

For the initial two to three days, the child may feel nausea. So, you should keep the child at home and then you can send the child to play school. One important thing, the drug for tuberculosis like Akurit-4, Rifacept-3 should be taken empty stomach in the morning.

Baseline liver function tests, kidney function tests, and uric acid levels should be done before starting the treatment. These tests should be repeated every month to see whether any derangement is present or not. If a derangement is seen, the dose of drugs needs to be changed. In all, I advise you to treat the child as a normal child and give the drug for tuberculosis daily.


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Hi doctor,

Thank you for your advice. Should we avoid cold foods like ice cream, etc?

Dr. Deepak Patel

Child Health Paediatrics
#

Hi,

Welcome back to icliniq.com.

There is no restriction for food. In fact, you can give everything to the child. Ice cream can be given in a limited quantity.


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