What is a 2-step Mantoux and why must I have it done?
All new PGME trainees must provide 2-step Mantoux results at the time of initial registration. 2-step Mantoux entails 2 TB skin tests done 1-3 weeks apart. Step 1 : 5 TB Units are implanted and the reaction is recorded 48-72 hours later. Step 2 : within 1-3 weeks, preferably at 1 week, another 5 TB units are implanted on the opposite arm and the reaction is read 48-72 hours later. Reaction is recorded in millimeters (mm). Only the induration (hardness) must be recorded, not erythema (redness). You must have the 2-step Mantoux regardless of your BCG vaccination history (unless if you have previously documented positive TB skin test results). PGME considers 10 mm or above in induration as positive. If you test positive on the first step, you do not need the 2nd step. You cannot provide chest x-ray (CXR) results as an alternative to TB skin test results. TB skin testing is used to detect latent TB infection, and CXR is effective in detecting active TB disease. Therefore, you should have t
