How long should I wait for my PPD after recent TB exposure....

[Bonesaw45]

I was working at a free clinic for drug users/homeless people today, the most they let us do is history intake and blood pressures. Most of it involves getting people into system so they can get into rehab and get their lives back together. Unfortunately today I ran across this really sick guy, had tons of problems I really felt bad for him. As I was going through the PMH he mentioned that when getting processed into prison over the summer he was told that he had TB. Who knows if the guys was active when he has so many other health problems being a TB carrier was low on his list (seriously this guy was hurting). I'm a little freaked out and I'm not looking for online diagnosis, I'm slightly overdue for a yearly PPD anyway and I was gonna make an appointment soon. What I am wondering is how long after exposure a PPD would give a pertinent positive/negative so I can schedule the doc appointment for that time, if its an immunological test it should take some until my immune system is primed I'm just missing the clinical picture of when it is primed.

Thanks

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[itsallthesame]

Unless you have HIV, you're going to be fine. Chances are very, very high that you are going to convert one of these years. Just get tested now and keep up with your yearly or semi-yearly tests. Latent TB is no biggie and as long as you don't become immuno-compromised you'll be fine. Chances that it'll become active in a normal young person w/in a year are slim to none.

Also, since a majority of your co-workers have likely converted, you shouldn't be any more scared of this guy than of them. Especially since he knows that he had TB it would be pretty unethical if he wasn't treated...

 

[ranmyaku]

To answer your question, a period of 2 to 12 weeks after primary infection is generally required for skin test conversion to occur.

You don't get TB from somebody with LTBI who is sick. You get TB from somebody who has active disease.

I see nurses all the time stick somebody in respiratory isolation b/c their PPD is positive, yet they have no symptoms.

 

[HPSPpayissues]

why do you even volunteer at those places anyway? Trying to pad your resume for your residency?

 

[MediumDef]

If you are working in a homeless clinic in an urban area I can almost guarantee some of your other patients have had TB as well and if being in the same room with someone who has TB is causing you to freak out you are going to have a long row to hoe ahead.

I'm not saying you shouldn't care about your personal health and take due precautions but you will find yourself in this situation or an analogous one many times in the course of your career.

 

[Gibbles]

why do you even volunteer at those places anyway? Trying to pad your resume for your residency?

Some of us care enough about humanity that we are willing to put ourselves in incredible situations and less-than-incredible healthcare opportunities. It's not self-righteous, but it is based upon the very foundations of medicine.

If you're not willing to sacrifice everything for your patients, then you are in the wrong field.

 

[Bonesaw45]

my previous posts would make it look like I'm trying to pad my resume, if thats why you posted it, but recently I decided its time for a reality check on what I'm gonna be doing for the rest of my life, its hard to get away from the undergrad mindset when you go straight through and I almost wish I had not just jumped in from college. I have gone to this site once every 1 - 2 months during schoool and I find that it rejuvenates my care about staying because I get practical applications and real life instead of annoying lectures. I knew this was likely to happen at some point in my career, just kinda annoyed that it is now when I'm a first year and have no means of fully understanding my personal chance beyond what I read from access med and I can't just stick myself with a PPD.

 

[njbmd]

my previous posts would make it look like I'm trying to pad my resume, if thats why you posted it, but recently I decided its time for a reality check on what I'm gonna be doing for the rest of my life, its hard to get away from the undergrad mindset when you go straight through and I almost wish I had not just jumped in from college. I have gone to this site once every 1 - 2 months during schoool and I find that it rejuvenates my care about staying because I get practical applications and real life instead of annoying lectures. I knew this was likely to happen at some point in my career, just kinda annoyed that it is now when I'm a first year and have no means of fully understanding my personal chance beyond what I read from access med and I can't just stick myself with a PPD.

First of all, get out the the mindset that people actually "care" about what you do. It's your career and anything that you do is your business. Second, go to your preceptor with these kinds of questions. Your preceptor is always the "point person" when you have these types of experiences. He/She can discuss the situation with you in detail (they know the patient) and assist you. Good luck.

 

[Re3iRtH]

Some of us care enough about humanity that we are willing to put ourselves in incredible situations and less-than-incredible healthcare opportunities. It's not self-righteous, but it is based upon the very foundations of medicine.

If you're not willing to sacrifice everything for your patients, then you are in the wrong field.

By everything do you mean even a doctor's salary? I doubt many of us would work for the US's average salary, about $20k/year. I personally have yet to
find these people with pure, selfless intentions.