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Hendrickson医生问:最近,我看到1名21月龄女孩经常规皮内结核菌素(PPD-5U)皮试后30分钟,前臂出现红肿,48小时后,皮试部位出现至少12mm的硬结和持久性红斑,胸部X片正常。她的家庭成员的结核菌素皮试阴性。我认为,该女孩对皮内试验产生了变态反应。这种速发型反应的发生率多少?这种反应有何诊断意义?她应象其他皮试48小时阳性的幼儿一样接受为期1年的异烟肼治疗吗?她应定期拍摄胸部X线片吗?她应该进一步接受PPD-lU作结核菌素皮肤试验吗?如果作皮试,她是否会发生更严重的局部或全身反应?
Dr. Hendrickson asked: Recently, I saw a 21-month-old girl with regular skin test tuberculin (PPD-5U) skin test 30 minutes after the forearm was red and swollen, 48 hours after the skin test site at least 12mm induration and Long-lasting erythema, normal chest X-ray. Her family member’s tuberculin skin test negative. I think the girl had an allergic reaction to the intradermal test. What is the rate of this rapid onset reaction? What is the diagnostic significance of this response? Should she be treated for isoniazid for 1 year like any other 48-hour-old child? Should she take chest radiographs regularly? Should she further undergo PPD-1U as a test for tuberculin skin? If she does a skin test, does she develop a more severe local or systemic reaction?