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A strongly reactive Mantoux means that she has been exposed to tuberculosis
bacilli and she has developed hypersensitivity
to tubercular protein, which is measured by the diameter of induration (red swelling) after 48-72 hours that develops at the site of tuberculin injection
given intradermally (in the skin of the forearm). A positive Mantoux test
doesn't always mean someone has TB disease; it just means that the bacteria have been in the body at some time. Also, a diagnosis of tuberculosis is never based solely on a Mantoux/PPD tuberculosis test. False-positive reactions to the tuberculosis skin test can occur because of:Infection with non-tuberculous or atypical mycobacteria
I recommend chest X ray and sputum for AFB three times.
Regards, Dr. Jagdish