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Definitions of positive tuberculin skin test (TST) results in infants, children, and adolescents*

Definitions of positive tuberculin skin test (TST) results in infants, children, and adolescents*
Induration 5 mm or greater
Children in close contact with known or suspected contagious people with tuberculosis disease
Children suspected to have tuberculosis disease:
  • Findings on chest radiograph consistent with active or previous tuberculosis disease
  • Clinical evidence of tuberculosis disease
Children receiving immunosuppressive therapyΔ or with immunosuppressive conditions, including human immunodeficiency (HIV) infection
Induration 10 mm or greater
Children at increased risk of disseminated tuberculosis disease:
  • Children younger than four years of age
  • Children with other medical conditions, including Hodgkin disease, lymphoma, diabetes mellitus, chronic renal failure, or malnutrition
Children with likelihood of increased exposure to tuberculosis disease:
  • Children born in high-prevalence regions of the world
  • Children with significant travel to high-prevalence regions of the world◊
  • Children frequently exposed to adults with HIV infection, who lack housing, or are incarcerated; or to people who inject or use drugs
Induration 15 mm or greater
Children age four years or older without any risk factors

* These definitions apply regardless of previous Bacille Calmette-Guérin immunization; erythema alone at TST site does not indicate a positive test result. Tests should be read at 48 to 72 hours after placement.

¶ Evidence by physical examination or laboratory assessment that would include tuberculosis in the working differential diagnosis (eg, meningitis).

Δ Including immunosuppressive doses of corticosteroids or tumor necrosis factor-alpha antagonists or blockers, or drugs used in transplant recipients.

◊ Some experts define significant travel as travel or residence in a high-prevalence region for at least one month.
Used with permission of American Academy of Pediatrics, from: Committee on Infectious Diseases, American Academy of Pediatrics. Tuberculosis. In: Red Book: 2024–2027 Report of the Committee on Infectious Diseases, 33rd ed, Kimberlin DW, Banerjee R, Barnett ED, et al (Eds), American Academy of Pediatrics 2024. Copyright © 2024 American Academy of Pediatrics; permission conveyed through Copyright Clearance Center, Inc.
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