Q: My child is 1 year and 3 months old. Recently, she was tested for primary complex and a Mantoux test resulted in 14 mm. But she didn't get a bump the BCG vaccine was given in her early days. Why did this happen and are there side effects of primary complex treatment?

A:Sometimes the BCG vaccination given at birth or immediately after birth fails due to variety of reasons, most often due to technical deficiencies in proper administration or improper storage of the vaccine. Absence of scar formation clearly indicates poor take. The Mantoux test (tuberculin test) is considered positive when it is more than 10 mm in diameter. If the children have a strongly positive tuberculin test, i.e. induration above 15 mm or more, they are likely to have disease in early childhood or develop disease. Decision to start treatment depends on the presence of clinical symptoms and other lab investigations. The treatment is generally safe but follow up evaluation, especially for liver toxicity, is important in infants and children.