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Heaf test

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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A Heaf gun with disposable single use heads is recommended.

The gun injects purified protein derivative equivalent to 100,000 units per ml to the skin over the flexor surface of the left forearm. The test is read between 3 and 10 days later. The injection must not be into sites containing superficial veins.

The reading of the Heaf test is defined by a scale:

  • negative - minute puncture scars, no induration
  • grade 1 - at least 4 puncture points are indurated
  • grade 2 - coalescence of puncture points forming a ring of induration
  • grade 3 - extensive induration (5 - 10 mm)
  • grade 4 - severe induration (>=10mm); may be central blistering

Grades 1 and 2 may be the result of previous BCG or avian tuberculosis. Children who have a grade 3 or 4 reaction require X-ray and follow-up.


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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