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A delayed, Tuberculin type response to intradermal (ID) test with benzathine penicillin is described in a 50 year old female. She did not develop any sign of drug reaction on receiving.intramuscular injection of that drug. None of the 65 patients who were studied in detail for the ID test response to various penicillins showed such a delayed response.

The interrelation between immediate and delayed hypersensitivity reactions to local anesthetics is poorly understood. Especially, the relevance of positive patch test reactions to local anesthetics with regard to the compatibility of injected local anesthetics is unclear. We therefore subjected 104 patch test-positive probands to prick and intradermal tests with seven local anesthetic agents. All prick tests were negative. Only 14 patients showed positive reactions in intradermal tests: 11 with the ester local anesthetic procaine, one with the amide local anesthetic butanilicaine, and two with both. Procaine yielded both immediate and delayed reactions; butanilicaine, only immediate reactions. All other local anesthetics showed negative reactions. It is concluded that in patients with positive patch test reactions to local anesthetics and negative history of anaphylactoid reactions, positive skin test reactions to intradermal application are rare and that, therefore, the risk of anaphylactic reactions to injection anesthesia with amide local anesthetics, except butanilicaine, appears low in these patients.

A partially purified Echinococcus antigen solution, prepared by boiling hydatid cyst fluid, was used in the intradermal test for hydatid disease in a Peruvian population. An unexpectedly high rate of positive reactions and poor agreement with serological tests suggested the presence of some agent(s) which produced cross-reactions with Echinococcus granulosus antigens in the intradermal test. Testing of hospital patients infected with a variety of helminths demonstrated nonspecific reactions in persons with Hymenolepis nana, Taenia spp., and Fasciola hepatica infections, mixed parasitisms, and several non-helminth pathological conditions. The findings contraindicated the use of the intradermal test for epidemiological surveys of hydatid disease. It is pointed out that intradermal test positivity rates cannot be used as synonymous with infection prevalence and regional differences do not necessarily reflect differences in the prevalence of E. granulosus infection. The greater specificity of some serological tests favor their use for epidemiological purposes.

Fifty patients with manic-depressive psychosis, 120 neurotics and 100 healthy individuals were studied. They underwent the toxoplasmin intradermal test. The highest percentage of reactors was found among patients with manic-depressive psychosis (66,0%). Patients with depressive neurosis accounted for the highest number among neurotics (55,6%). The intensity of reaction was higher among patients with manic-depressive psychosis. Neurotic patients were compared to schizophrenic patients from a previous study conducted by one out of the authors. It is concluded that the percentage of reactors is higher among patients with depressive mental disorders, and also that this percentage increases with mental deterioration in patients.

The intradermal test of this disease was performed by injecting 0.02 ml of the antigen into the middle third of the volar surface of the forearm; the reaction was judged after 15 minutes and a diameter of 9 mm or more in wheal and/or 20 mm or more in erythema were regarded as the positives. The following results are presented on this basis. (1) The percentages of the dermal reactors for the subgroup by age were shown in Table 1. Age was important in the sensitivity of the intradermal test with schistosome antigen; the percentage of positive reactors was significantly higher in the adult group compared with the younger three groups as Minor 1, 2 and 3. The rates of dermal reactors were reduced in the adult group from 40.5% in 1973 to 17.8% in 1976. Lowering the concentration of nitrogen to 10 micrograms per ml in the antigen showed a decrease of the sensitivity in the intradermal test in all age groups. (2) Sex was important in the sensitivity of the intradermal test and males had a higher positive rate than did females; there was a significant difference in the percentage of the positive reactors between the sexes in the same age groups in both West and East parts of the survey area (Table 2). (3) It was noted that the percentages of the dermal reactors were higher for those in the West part than those for the East part as shown in Tables 3 and 4 and Figures 1 to 5. There was a close correlation between the distribution pattern of the wheal diameter and the positive rate for the intradermal test in the same area; this was shown in Figure 6 and also evidenced by a shift to the right of the frequency distribution curves in Figure 9. (4) These results indicate that the intradermal test with schistosome antigen proved to be satisfactory for observing epidemiological status of this parasitic disease in the endemic areas. It was also suggested that such snail-control practices as cementing irrigation ditches and periodic application of molluscicide, and the mass-treatment of infected persons might be effective in reducing transmission among peoples over a considerable area in Yamanashi Prefecture.

Histamine diphosphate was injected intradermally, at dilutions of 10(-3), 10(-4), and 10(-5), into 25 boys (10--12 yr old), and 25 men (20--30 yr old) with active schistosomiasis mansoni. A linear relationship between the mean area of the wheals and the logarithm of histamine concentrations was determined. Both equations (men and boys) were significant (P less than 0.05) but showed no difference between their regression coefficients. These findings contrast with those obtained with the intradermal test performed with Schistosoma mansoni antigens, in which skin response in men is significantly greater than in boys.

The capacity of tegobetain, pyrrolnitrin, tolcyclate and chlorquinaldol to induce delayed-type contact sensitization was studied in guinea pigs in 2 series of tests using the method of Magnusson & Kligman and the authors' modification of the wholly intradermal Draize technique. Histological examination of skin biopsies obtained from the test area demonstrated that tegobetain, pyrrolnitrin and tolcyclate are potential sensitizers.

To compare two different sources of bird-antigens (intestinal extracts versus serum dilutions) we performed intracutaneous tests in 79 birdkeepers (34 pigeon-, 20 hen- and 25 budgerigar-keepers) and in nonexposed control persons. The bird-exposed persons were divided into 3 groups: 1. Seropositive patients with extrinsic allergic alveolitis (EAA), 2. seropositive persons without any signs of EAA (sensitized asymptomatics), and 3. exposed seronegative healthy persons. The results of the investigation demonstrate that the early skin-reaction (20 minutes after antigen-application) is nonspecific and do not have any diagnostic value. Most of patients with EAA (65.7%) and 29.6% of sensitized asymptomatics developed a positive 6-hour-(Arthus-) reaction with intestinal extracts, whereas in control groups we have not seen any Arthus reaction. Consequently, we recommend the use of intestinal extracts in the diagnostic procedure of EAA.

An intradermal test (delayed hypersensitivity test) for the diagnosis of BHV1 infection was evaluated in 791 cattle of 16 dairy farms. The skin reactions were compared with the results of serological examinations using a commercial BHV1 ELISA kit (Trachitest). As antigen concentrated, purified and inactivated BHV1 was used. The skin reaction (increase of the skin fold thickness) was used for the interpretation of test results. The best results were obtained with the control of the skin reaction on the third day after injection of the antigen. From 393 serologically BHV1 negative cattle with an age of more than 6 months 391 (99.5%) had a skin reaction up to 1.0 mm and 2 animals (0.5%) had a reaction of 1.3 and 1.9 mm, respectively. The mean increase of skin fold thickness was 0.2 mm. Out of 291 serologically BHV1 positive cattle with an age of more than 6 months 270 had antibodies from natural infection and, partially, from additional vaccination with inactivated BHV1 vaccine. 266 (98.5%) of these animals showed a skin reaction of more than 2.0 mm, in 3 animals (1.1%) a skin reaction up to 1.0 mm was observed and 1 animal (0.4%) had a reaction of 2.0 mm. The mean increase of the skin fold thickness was 6.3 mm. 21 animals had BHV1 antibodies only because of vaccination with inactivated BHV1 vaccine. Only 4 animals had a skin reaction of more than 2.0 mm. Among 107 animals with an age up to 6 months 30 were serologically BHV1 positive and 77 were BHV1 negative. In all animals the skin reaction was less than 1.0 mm, the mean was 0.2 mm.

The percentage of strongly positive reactions to intradermal testing of 2,997 pregnant women was found to grown continuously by about one per cent per annum along with growing age. -- The conclusion drawn from comprehensive discussion of the above findings is that cellular immunity is likely to grow rather than decline, as assumed in the past, following toxoplasmosis infection. However, the increase, about one per cent annually, is of minor dimensions and might be based on a booster effect. -- This would mean, after all, that the intradermal test will continue to be of informative value, even long time after the infection, for example, in the context of aged patients. Therefore, no correction is required either by the criteria of interpretation.

A clinical study to evaluate the Makari Intradermal Test (MIT) involved 180 patients seen with symptoms suggestive of malignant disease, 85 of whom were subsequently shown to have carcinoma of the large bowel, and 66 asymptomatic volunteers. The prognostic value of initial and serial studies relative to patient-survival rate and the efficacy of serial studies in detecting disease in long-term follow-up of patients with resected malignant lesions were evaluated. On the basis of this study, the MIT appears to merit further investigation, not as a definitive diagnostic procedure, but as a survey for identifying patients with early malignancy or individuals at high risk to malignant epigenesis.

RAST and intradermal testing correlated reasonably well for untreated patients for ragweed and molds and in treated patients for trees. Capillary blood was found to be comparable to venous blood as a source for RAST for ragweed and mixed grasses.

Quidel Allergy Screen (QAS), an enzyme-linked immunosorbent assay, has been developed for measuring IgE antibodies against 9 allergens (HD 1, HD 2, Mite 1, Mite 2, Japanese cedar, ragweed, cat dander, sweet vernal grass, and egg white) at the same time. To determine whether this assay is useful in screening allergen-specific IgE antibody, we compared the titers of IgE antibodies against the 9 allergens measured by QAS to the obtained in skin prick tests, in intradermal tests and by RAST in 93 atopic asthmatics and 25 normal subjects. We found a good agreement between the reactivity of skin prick tests and the reactivity of QAS. There was a significant correlation between the threshold doses of intradermal tests and the titers of QAS. We also found a good agreement between the reactivity of RAST and the reactivity of QAS, and a strong correlation between the titers of RAST and the titers of QAS. Thus, it is concluded that QAS is useful in screening IgE antibodies against multiple allergens simultaneously.

Reference is made to an earlier study into the usefulness of the intradermal test. Now, an account is given of the specificities of tests used at present for the detection of toxoplasmosis, with reference being made to 4,341 intradermal tests, 1,332 dye tests, and 880 complement fixations. -- The three methods are qualitatively and quantitatively compared in great detail, with the close correlations between them explained. Reference is also made to the different origins of the antibody types detectable by the methods concerned. -- It seems to be quite obvious that the production of those antibody types differs in time and site, just as their lives are different in length. These findings actually are used as a point of departure for more detailed methodical proposals that should be followed in the search for an acute infection with Toxoplasma gondii. -- Various effects which might lead to unspecific tests are described in some length. -- All the above studies and findings have been used to compile a diagnosis diagram which may be a good basis for clinical decision-making on therapy.

The diphtheria antitoxin titres determined in human sera by the intradermal titration method have been compared with the titres obtained by a range of ELISA assays. A direct ELISA based on highly purified diphtheria toxoid correlated poorly with the in vivo method but an assay based on capture of toxoid by a non-neutralizing monoclonal antibody produced results that correlated very well. The performance of assays involving partial blockade of antigen and non-neutralizing monoclonal antibodies was intermediate.

The single intradermal comparative test was used with both avian and bovine tuberculin. Three cattle infected with bovine leukosis virus (BLV) were used as a source of infection. BLV-positive and susceptible animals were tuberculin tested alternately. Fifteen susceptible calves and 15 susceptible sheep were tested. A further three valves and three sheep were used as controls; the needles of the tuberculin syringes were deliberately contaminated with blood from the BLV-infected cattle, before being used in the test. Whereas all three calves and the three sheep inoculated intradermally with contaminated needles developed BLV infections, all of the other 30 animals have remained serologically negative to BLV for 10 months. Transmission of BLV with needles contaminated with BLV-infected blood was prevented by wiping the needles with absorbent cotton wool.

An intradermal test was developed to screen cattle for infection with the first-instar larvae of the warble flies Hypoderma lineatum and H. bovis. The diagnostic antigen, prepared from the first-instar larvae of H. lineatum, produced a distinct dermal reaction in cattle infected with the first-instar larvae of either species, but not in cattle in which the infection could not be confirmed later either on necropsy or by the appearance of warbles in the back. The reaction to the antigen was unpredictable in cattle with warbles in their backs. The diagnostic property of the antigen was also demonstrated in rabbits and guinea pigs artificially sensitized to the antigen.

Variations of intradermal test results were studied in a group of patients with clinically evident contact dermatitis and with the history suggestive of contact with metals and with negative patch tests reactions to the latter. The positive reactions obtained in several cases indicate that intradermal tests may reveal specific sensitivities, which patch tests using standard concentrations are not always capable of demonstrating.

The skin test was performed in cattle infected with C. bovis. The examination were carried out on naturally (23 head) and artificially infected animals (20 head) at different times after infection. Antigens prepared from T. saginata (B1, N0.1, C, Calk) and antigens extracted from activated oncospheres of T. saginata (OI and OII) were inoculated intradermally. The most active were the antigens B1, N0.1, and C prepared from T. saginata. In the majority of infected animals the antigens produced the immediate type of reaction developing the maximum intensity during 2 h post injection. It is worth mentioning that Arthus-type responses have often been observed. Uninfected animals when tested with the same antigens developed mild reaction, not exceeding 4 mm skin thickness. The second testing of the same animals after one or five months resulted in a more intensive reaction slightly resembling that one observed in infected animals. There is no correlation between titre of passive haemagglutination test and the skin test reaction in naturally infected animals. Neither the number of cysticerci with which the animal is infected has an influence on the degree of the skin edema.

To determine reproducibility and the optimal way of expressing skin sensitivity, simultaneous skin prick tests (SPT) and intradermal tests (ICT) were performed on 25 mould-allergic patients. The patients had a well-documented history of allergy to Cladosporium and Alternaria and were tested with partially purified standardized extracts of these two mould species. Skin prick tests were carried out on the volar side of the forearm and intradermal tests on the backs of the patients. The skin tests were performed as titration using quadruplicate determinations of 10-fold allergen dilutions. The area of the skin reactions measured by planimetry were plotted in a log-log system as a function of the allergen concentration. The reproducibility (SD/mean area X 100%) of the ICTs was significantly higher than that of the SPTs (17% versus 29%). A very low reproducibility was found with wheal areas less than 5 mm2. The dose response curve of the SPT wheal area was steeper than that obtained with ICT, both concerning ICT wheal and flare. Increasing the allergen concentration with a factor 10 resulted in a doubling of the wheal area in SPT, in contrast to a factor 1.7 using ICT. The coefficient of correlation using linear regression on the dose response curve was always higher than 0.9 with SPT and ICT wheal, but significantly lower with ICT flare. Skin sensitivity was estimated as end-point and histamine equivalent reaction. No significant correlation between SPT and ICT end-point titration was found contrary to the histamine equivalent reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

A group of 143 dogs and cats with pruritic skin disease was tested by intradermal injection of a dilute whole cat flea extract. The test results were correlated with the clinical diagnosis (Table I, III), with previous or present findings of fleas on the animals (Table II, III), with the presence or absence of blood eosinophilia (Table IV), and, in animals with clinical flea allergy, with the histological findings in a skin biopsy excised from a clinically affected skin site (Fig. 1). The predictive value of a positive and a negative outcome of the test was assessed graphically by means of calculations described in the Appendix (Figs. 2, 3). It is concluded that the test is sufficiently specific to justify its use in animals where flea allergy is suspected but cannot be proved by routine clinical examination. The histological findings and the nature of the skin reactions suggest that a positive outcome of the test is indicative of an immediate, type I hypersensitivity towards components of the oral secretion of fleas and that this hypersensitivity is mediated by reaginic antibody which to some extent is produced by plasma cells located in skin areas where flea saliva is deposited.