Use of results of the intradermal reaction (IDR) in treatment decision-making for investigations following a case in a child under 15 years old or above* (from the Higher Public Hygiene Counsel for France 2003)

IDR swellingIn the situation of an investigation following a caseExposed occupation (initial and follow-up)
<5 mmMonitor at 3 monthsIDR negative
Old or recent LTBI unlikely
No treatment
Monitor according to the risk of the occupational sector**
Between 5 and 9 mmMonitor at 3 monthsIDR positive
Reaction due to BCG or LTBI but in favour of recent LTBI
No treatment
Monitor according to the risk of the occupational sector**
Between 10 and 14 mmMonitor at 3 monthsIDR positive
Probable LTBI
The context will help to define the length of history.
If context favours recent LTBI
Treat if not
Monitor according to the risk of the occupational sector**
>15 mmIDR positive
Probable recent LTBI
treatment

* This is treatment of TB infection after excluding TB disease; ** Opinion of the CSHPF (Higher Public Hygiene Counsel for France) dated 15/11/2002. For immunosuppressed people in whom the IDR may be falsely negative, the decision is taken according to the type, degree, and duration of the immunosuppression.

From: Tuberculosis: Place of vaccination in control of the disease

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