I tested postive for the TB test

[Ooglyboogly]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

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[prettyslick]

Check with the individual hospitals. Most hospitals ask for a TB test to be done while some don't. Also, don't ask them really but just apply to different hospitals and see which one takes you. I don'y know how serious your issue is. Perhaps, even if your TB test comes back positive (which it probably will) then you can try to explain your situation to the hospital itself.

 

[nonesuchgirl]

If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

1. Take the meds.
2. Yes, you will always pop positive on a skin test while you've got TB bugs in your system.

3. They will almost certainly require a cxr.

4. Not if it is not an active infection.

 

[patekpremed]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

You are MUCH better off and safer to go ahead and take the medication for a year. The side effects are a gamble, as they are with ANY drug you take. Unless you are extremely unlucky, I wouldn't think that any of the common side effects (rash, itching, etc) would have a drastic impact on your GPA. Instead of not "risking [your] GPA," how about not "risking" your life....take the meds

 

[sunny1]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

You can still attend medical school if you had a positive TB skin test. You'll likely need to provide proof of the negative chest x-ray and a note from your doctor. In terms of the specific requirements for med schools and volunteering in hospitals, I'd contact them individually to see what their policies are.

On a more important note, if my doctor suggested I take the medicine for latent infection, I'd follow the suggestion of my doctor. Personal health >>> GPA in my opinion. You can learn more at CDC's website. Obviously SDN isn't the place for medical advice and only your doctor knows your specific situation. Perhaps you don't really need treatment. I'm not giving you any medical advice, just saying that I'd probably follow the suggestion of my doctor and that personal health should trump GPA.

 

[Phillykid162]

1. Take the meds.
2. Yes, you will always pop positive on a skin test while you've got TB bugs in your system.

3. They will almost certainly require a cxr.

4. Not if it is not an active infection.

That sums it up quite nicely. I tested positive as well, probably because of a BCG vaccination, but you should just provide the hospital with a copy of the negative CXR. I've been on INH for a month and haven't had any side effects, and certainly not a drop in GPA. You should definitely take the medication as it reduces the likelihood of the bacteria becoming active. Once that happens...

Anyway best of luck

Edit: I posted about this recently lol http://forums.studentdoctor.net/showthread.php?t=513484&highlight=LTBI

 

[Depakote]

Please limit your responses to the scope of the OP's medical school applications and refrain from providing advice regarding medication which would be best handled by his or her healthcare professional.

 

[Depakote]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

It is generally required that you take a TB test annually to work in the healthcare industry. If you have previously tested positive, you must get a chest x-ray (rather than the skin test) to show that you do not have an active infection. A school cannot discriminate against you from an admissions standpoint for having an active TB infection, however they may not allow you to see patients unless it has been treated.

 

[skypilot]

1. Take the meds.
2. Yes, you will always pop positive on a skin test while you've got TB bugs in your system.

3. They will almost certainly require a cxr.

4. Not if it is not an active infection.

You will never have to take the skin test again. You probably will have to provide proof of your negative CXR but current rules are that you will not have to get a chest xray periodically.

 

[nonesuchgirl]

You will never have to take the skin test again. You probably will have to provide proof of your negative CXR but current rules are that you will not have to get a chest xray periodically.

Institution dependent.

Mine requires PPD/CXR/something every year, regardless.

 

[da me ka don]

I was born in Nigeria, and I always test positive for the skin PPD. However, I have never been placed on any type of medication. I only get sent to take a chest Xray. The chances of it becoming active are very minimal. Btw, my mom was put on some medication (???) and her side effects were awful. But again, she's older so that might be the cause.

 

[nu2004]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

to work you'll need the skin test, and then the chest x-ray.

no, med schools cannot refuse to allow you to attend, though they may want copies of your chest x-rays or to do the x-ray themselves.

your doctor or workplace may recommend that you have chest x-rays at a set interval (e.g. yearly), but i'm not sure. just make sure you have some lead over your nuts when you get the chest x-rays. you'll be getting exposed to more radiation than most people your age and there's no reason to put undue stressors on your gametes.

 

[Cardiac]

I was born in Nigeria, and I always test positive for the skin PPD. However, I have never been placed on any type of medication. I only get sent to take a chest Xray. The chances of it becoming active are very minimal. Btw, my mom was put on some medication (???) and her side effects were awful. But again, she's older so that might be the cause.

If you have ever had the vaccine to TB, you will always test positive to PPD skin tests. I'm pretty sure that part of Nigeria's anti-TB campaign is to vaccinate young children with the BCG vaccine (the vaccine is only really effective for kids). You probably had the vaccine and that's why you're testing positive.



To the OP, get the meds. Now. Not only is it dangerous to your health, if it becomes active, you may not notice it for a while. If you're so focused on grades, you don't seem like the type of person who's going to get checked out every time you have a cough, so if it does become active, there is a chance that you will transmit it before you notice the symptoms.

If you only understand arguments in terms of your med school applications, having any sort of TB will stop you from hospital volunteering, seeing patients in MS3/4, working in some labs, and working for a hospital in almost every way. I know that i had to pass a TB test to work in a lab (non-clinical) that was owned by the hospital, even though it was in a different part of town and never sees patients.

 

[HumidBeing]

There was a recent thread about positive PPD tests. The circumstances were different, but you may find some helpful information posted there. Here's a link.
http://forums.studentdoctor.net/showthread.php?t=499393&highlight=chest+xray

 

[akzeno]

Okay, first of all you should google TB and see under what circumstances they can come up as positive. One situation that I know of is that there is a common vaccine adminstered to children born during approximately 1980-1986(?) which can show the test result of a positive TB test however, you actually don't have TB. I believe this vaccine was administered in developed asian countries only such as Japan, Korea, etc.

In addition, if you actually do have TB, then take the meds for God sake. This isn't some cancer or psychological medication in which you'll have serious side effects. Just think about it as Tylenol times several degrees more potent. You WILL BE FINE and your grades won't suffer unless YOU slack off.

For this year, you probably won't be able to volunteer in a hospital unless your TB is non-cantagious. Even then, some hospitals won't let you volunteer due to their policies. If so, do something else. Volunteer in a nursing home or do research, whatever you want. You can volunteer at a hospital next year and if worse comes to worse, your physician can sign off saying that your TB is no longer an issue.

I am 99.9999% sure no medical school will deny you admission because you have TB lol. This is ludicrous. TB is a perfectly treatable disease and do as your doctor told you to do and take the damn medicine. By the time you apply to medical school your TB issue will be taken care of and everything will be fine.

Trust me, you have absolutely nothing to worry about this minor case.

 

[EpiPEN]

My college roomate had latent TB and we roomed for 2 years. I know he doesn't take meds for it and so far no one around him has caught TB yet. But I still get the feeling that he's a walking time bomb...

 

[notdeadyet]

Ooglyboogly- Sorry to hear about the results. Follow doctors orders and take the meds. The side effects are over-stated. My wife was on them and didn't notice a thing.

She did find it hard to not drink alcohol for the six months that you're on them. It's easy to poo-poo that rec for antibiotics and whatnot, when alcohol can reduce the effectiveness, but she was told that alcohol + INH really knocks your liver silly. Listen to your doctor on this.

The biggest impact of the TB result for her has been the permanent spike in health insurance. After the positive (but latent) TB test, she's had to report this on every health insurance application she's done. Even the cheapest Blue Sheild/Blue Cross account has quoted her over $400/month due to her "pre-existing condition". It would make you laugh were it not such a blow. She had to go without insurance for over a year util we came to medical school. Private insurance (which she always needed prior to us getting married, as a contract worker) is no longer a viable option for her.

Yet another example of why our healthcare system is so messed up. Permanently penalize someone for doing the proactive thing which results in no burden on the insurer. Don't even get me started.

 

[antihero94]

Think about it:

1) Why would doctors want you to get treated? If the risks and benefits of not treating out-weighed the risk and benefits of treating, no doctors would treat TB. TB is a TERRIBLE disease. I once had a 95 year old man we were telling had lung cancer. He replied "well at least it is not tuberculosis." People who grew up before modern antibiotics can attest to the dangers of this disease. I suggest googling "miliary tuberculosis."

2) The reason hospitals want you to get treated is so you don't spread it to patients. Especially immunocompromised patients (AIDS, SCID). So stop thinking about ways to get around this for yourself and think about OTHERS. If you don't want to get treated because it might hurt your GPA, then don't work in a hospital.

3) If you are completely unwilling to follow the norms of medical treatment do you think a career in medicine is for you?

 

[nonesuchgirl]

blah blah blah

Dude, chill out.

He doesn't OMG HAVE TB!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

He popped positive because he's got the bugs. The same way we all have gut bugs and people who've been hanging out with kids with mono get EBV antibodies.

That said, he does need to treat it, because god only knows when/if it'll stop being latent and start being OMGGGGGGGGGGGGGGGGGGGGGGG TB.

 

[Ooglyboogly]

Think about it:

1) Why would doctors want you to get treated? If the risks and benefits of not treating out-weighed the risk and benefits of treating, no doctors would treat TB. TB is a TERRIBLE disease. I once had a 95 year old man we were telling had lung cancer. He replied "well at least it is not tuberculosis." People who grew up before modern antibiotics can attest to the dangers of this disease. I suggest googling "miliary tuberculosis."

2) The reason hospitals want you to get treated is so you don't spread it to patients. Especially immunocompromised patients (AIDS, SCID). So stop thinking about ways to get around this for yourself and think about OTHERS. If you don't want to get treated because it might hurt your GPA, then don't work in a hospital.

3) If you are completely unwilling to follow the norms of medical treatment do you think a career in medicine is for you?

I totally understand what you are talking about. The thing is, I was told that the probabilty of someone with latent TB developing active TB is 1/10. So, I was just thinking, if the chance of it developing into active Tb is 1/10, then why should I risk taking the medicine if it will give me the side-effects? I guess I'm going to have to talk more about this with my family doctor.Thanks for the advice

 

[nonesuchgirl]

I totally understand what you are talking about. The thing is, I was told that the probabilty of someone with latent TB developing active TB is 1/10. So, I was just thinking, if the chance of it developing into active Tb is 1/10, then why should I risk taking the medicine if it will give me the side-effects? I guess I'm going to have to talk more about this with my family doctor.Thanks for the advice

Side effects tend to be over-emphasized. x people out of 500x got this that or the other thing.

Just take the meds, get clear.

 

[Bacchus]

I totally understand what you are talking about. The thing is, I was told that the probabilty of someone with latent TB developing active TB is 1/10. So, I was just thinking, if the chance of it developing into active Tb is 1/10, then why should I risk taking the medicine if it will give me the side-effects? I guess I'm going to have to talk more about this with my family doctor.Thanks for the advice

You're physician is not talking about a rogue treatment. I would file the medication under "Prophylaxis" because despite not having an active case, your physician (who knows you) wants to treat you proactively instead of retroactively. Sure, he may be trying to be covering himself but I am sure that he has your best interests in mind.

You must also call any healthcare association you want to work in to see their protocol for latent TB employees. As a volunteer there is a bigger "inherited" risk working in the hospital because you are not covered under the same protocols as hired employees, I believe. Its that magic word, liability.

 

[bola]

OP-I'm in the same boat as you are and refused to take the meds. The possible side effects are a little to many and even my health care provider did not put any pressure on me to take the meds. She gave me a bunch of publications to read about it and when I came back with a "NO" she completely understood.

Assuming you stay healthy and don't become HIV positive, there is only a 10% lifetime chance that the latent infection will be reactivated. If you become immunocompromised for any reason(esp CD4 cell loss), then the odds change from a 10% lifetime chance to a 10% annual chance of you getting the reactivated infection (I got this data from an infectious disease talk and can't send you anywhere for a reference so take it as you will)

If you grew up in Africa, India etc you probably have a latent infection whether or not you took BCG due to sheer exposure to people with the disease.

In my institution I was told that the only repercussion of a positive test with a negative X-ray will be heightened caution anytime I have a weird cough and also more frequent X-rays(I can't remember how often). You should in no way be discriminated against based on this since you are currently (and will probably not become) infectious.

 

[DoctorPardi]

It is generally required that you take a TB test annually to work in the healthcare industry. If you have previously tested positive, you must get a chest x-ray (rather than the skin test) to show that you do not have an active infection. A school cannot discriminate against you from an admissions standpoint for having an active TB infection, however they may not allow you to see patients unless it has been treated.

Also a lot of places will require a chest x-ray if you have EVER come up positive from a tb skin test. So unfortunately you are likely to be facing a yearly chest x-ray on top of your skin test.

 

[notdeadyet]

Also a lot of places will require a chest x-ray if you have EVER come up positive from a tb skin test. So unfortunately you are likely to be facing a yearly chest x-ray on top of your skin test.

Most hospitals will not require that the OP ever have a skin test again. Once you mark on your health form that you tested positive on a skin test, you're not asked to do it again, since you'll test positive for life. Instead, you've got annual chest x-rays to look forward to for the length of your employment.

 

[BurnEmUpBears]

Having latent TB won't keep you out of medical school.

Take the medication! The side effects are not as bad as they are made out to be, and of the people I know that had to take INH, their only side effect was grumpiness about not being able to drink alcohol. Treatment of latent TB is the only way to break the cycle of transmission, and as a future doctor you need to take up this responsibility.

Yes, you have a 10% chance of developing active TB, and that's a 10% chance of becoming very sick, a 10% of having to take a combination of stronger antibiotics, a 10% chance of infecting others (including your patients) and continuing TB's cycle of disease/death. Treating latent TB is a cornerstone of preventative medicine and public health. Please take the medication.

 

[RapplixGmed]

This is slightly off topic but related.

I was born in China and got the BCG vaccine for TB so I ALWAYS turn up positive for TB and have to get chest x-rays done. Its a hassle. but the real question is why doesn't this vaccine get used more often in the US?

 

[GreenShirt]

I cannot believe what I am reading. It's incredibly selfish for someone to say "Oh, there's only a 10% chance of infecting my friends, family, loved ones, and patients with a potentially deadly disease, so no big deal". I can't even imagine having to live with that on my conscience. Why would you even take that slight risk if there's a simple treatment for it out there?

 

[flip26]

Most hospitals will not require that the OP ever have a skin test again. Once you mark on your health form that you tested positive on a skin test, you're not asked to do it again, since you'll test positive for life. Instead, you've got annual chest x-rays to look forward to for the length of your employment.

I did not know that - there is a pretty hefty health risk attached to having all those chest X rays - that would really suck to be in that boat.

 

[GreenShirt]

This is slightly off topic but related.

I was born in China and got the BCG vaccine for TB so I ALWAYS turn up positive for TB and have to get chest x-rays done. Its a hassle. but the real question is why doesn't this vaccine get used more often in the US?

TB is not prevalent enough in the US to merit mass vaccination. The vaccine is really only effective in children. Once those children grow up, it complicates the use of the PPD test since they would all test positive and have to get more expensive tests to rule out the possibility of infection. The CDC has a PDF on the BCG vaccine: http://www.cdc.gov/tb/pubs/tbfactsheets/BCG.htm

 

[GreenShirt]

I did not know that - there is a pretty hefty health risk attached to having all those chest X rays - that would really suck to be in that boat.

There's a blood test called the QuantiFERON-TB Gold (QFT-G) that can be used instead of the PDD or x-ray and is not sensittive to the BCG vaccine. I'm assuming this test is more expensive than the other two so it doesn't get routinely used, but it might be an alternative to being radiated every year.

 

[johndorian32]

When I first started volunteering at the hospital, I was required to take a TB test. The results were positive due to the fact that I was born in Europe and had the BCG vaccine, so I was in the same position as you. The nine-month medication for TB is optional, which I decided not to take. As long as you have the infection, but not the disease, you will be ok to volunteer.

 

[Milamber]

@ The OP I currently work for the Bureau of TB Control in NYC, so I have experience in this field. First thing is first a positive PPD, TST (The same thing just different names) or Quantiferon (blood based) test will should not affect you in anyway shape of form in regards to school as long as you are AFB smear and culture negative for M. TB. A chest x-ray is only used to rule out a pulmonary infection and TB can be active in other areas of the body. I recently had a patient who was TB+ in their psoas muscle. Now if the disease is extra pulmonary and not pulmonary then there is a very small chance that an individual close to you can catch it.

Next I suggest that you take the medication and adhere to the schedule because of the risk of developing a drug resistant strain. Either take the medication according to schedule or don't take it at all, there is no point in taking medication if you aren't going to follow the correct guidelines and when there is the possibility of developing a strain that is resistant to first line drugs. I would suggest that you have your doctor, if he hasn't all ready, perform a drug sensitivity test. This test will indicate if the strain of TB that you currently have is resistant to any first line drugs and if it is resistant to any of the first line drugs a substitution can be made so you aren't being treated with a failing regimin.

There may be complications with the medication, I personally try to ensure my patients are off of EMB as soon as possible, I have seen fewer than 1 in 200 who actually develop problems and when they do we change their regimen. If you are worried about side effects of the medication I can always find the link to the CDC's website regarding the side effects.

While latent TB is not infectious and not currently harmful to your body the potential for it to become active will always exist. Taking the medication will significantly reduce the possibility of you ever developing active TB. In the future you will never have to take another PPD or TST again just make sure you take a chest X-Ray instead because you will always come positive for the test.

Many physicians aren't well versed in the treatment of TB because it isn't a disease common in this part of the world but if they do have questions they can call up the NYC Dept of Health and speak with one of our staff physicians. Also if you care to read up on information you can always check out the following websites.

NYC Dept of Health TB Website

NYC Dept of Health TB Educational Resources

If you are worried please look these sites over for information or you can PM me for more info or questions.

 

[Mayday]

Ask your Dr's advice, then do what your Dr tells you. If he advises to take the meds, then listen to him - he has a damn good reason for his advice.

 

[patzan]

OP-I'm in the same boat as you are and refused to take the meds. The possible side effects are a little to many and even my health care provider did not put any pressure on me to take the meds. She gave me a bunch of publications to read about it and when I came back with a "NO" she completely understood.

Assuming you stay healthy and don't become HIV positive, there is only a 10% lifetime chance that the latent infection will be reactivated. If you become immunocompromised for any reason(esp CD4 cell loss), then the odds change from a 10% lifetime chance to a 10% annual chance of you getting the reactivated infection (I got this data from an infectious disease talk and can't send you anywhere for a reference so take it as you will)

If you grew up in Africa, India etc you probably have a latent infection whether or not you took BCG due to sheer exposure to people with the disease.

In my institution I was told that the only repercussion of a positive test with a negative X-ray will be heightened caution anytime I have a weird cough and also more frequent X-rays(I can't remember how often). You should in no way be discriminated against based on this since you are currently (and will probably not become) infectious.

You are exactly the type of patient that drove me crazy through medical school. I know that there are side effects to medications, but INH is pretty benign except for elevating liver enzymes in some people (OP: It is NOT going to drop your GPA) and some other rare effects.

You are a good example of someone who had a doctor reveal too much information. Nobody would take any medication if the doctor always told them all the side effects. "This has caused seizures, nausea, vomiting, weakness, runny noses, and DEATH in some patients...but it's your choice. Oh yeah, it's aspirin, but it can kill you - just think about if you really want to put that in your body before deciding."

1/10 is a very large risk. INH drops that to 1/10th of 1%. You will not have to ever get a PPD skin test again, but you will likely need chest x-rays yearly or every time you go on to a new place (away rotations, residency, job, etc.). Someone else made the very good point of thinking about all the people you could potentially infect and kill if you ever developed reactivation TB.

Taking the medication is recommended by every agency and physician with a brain because the risks are outweighed by the benefits in enormous proportions.

Oh yeah, supposed to stick to the application stuff...take the meds, follow your doctor's advice, and apply like any regular Joe.

 

[The Nephilim]

I tested positive too. It's not a big deal at all. You just take the meds for a long time and then you're fine. I was in school at the time and it didn't effect me at all. So no worries there. Though, the antibiotics messes with your vitamin B levels, so have lots of that. They said it would cause neuropathy if you weren't careful.

 

[bola]

You are exactly the type of patient that drove me crazy through medical school. I know that there are side effects to medications, but INH is pretty benign except for elevating liver enzymes in some people (OP: It is NOT going to drop your GPA) and some other rare effects.

You are a good example of someone who had a doctor reveal too much information. Nobody would take any medication if the doctor always told them all the side effects. "This has caused seizures, nausea, vomiting, weakness, runny noses, and DEATH in some patients...but it's your choice. Oh yeah, it's aspirin, but it can kill you - just think about if you really want to put that in your body before deciding."

1/10 is a very large risk. INH drops that to 1/10th of 1%. You will not have to ever get a PPD skin test again, but you will likely need chest x-rays yearly or every time you go on to a new place (away rotations, residency, job, etc.). Someone else made the very good point of thinking about all the people you could potentially infect and kill if you ever developed reactivation TB.

Taking the medication is recommended by every agency and physician with a brain because the risks are outweighed by the benefits in enormous proportions.

Oh yeah, supposed to stick to the application stuff...take the meds, follow your doctor's advice, and apply like any regular Joe.

Wow no need to get worked up...I am well aware that in many cases side effects usually affect only a fraction of a percentage of users. Perhaps I should have added that, if I happened to have taken the medication and cleared up the latent infection, when I went back home on vacation and such, there will be a good chance of re-exposure. So considering the lifetime chance of reactivation of a latent infection, the rigorous regimen and other factors...I was a better candidate for monitoring than treatment.

So at least in my case, it's a little more complex than just the side effects alone except I decide to stay within the confines of the US and other developed countries for the rest of my life...as you can see, it's hard to paint all cases with large brush strokes without considering the specifics.

Oh, as for forcing out information from my doc-not so. She gave me all the information without any prompting and handed me the papers to read and get back to her with a decision.

OP: Your case is clearly different from mine so please discuss this issue with your physician and not us random folks here. Like has been said multiple times this shd not affect your chance of admission. PERIOD.

 

[Brock Samson]

I cannot believe what I am reading. It's incredibly selfish for someone to say "Oh, there's only a 10% chance of infecting my friends, family, loved ones, and patients with a potentially deadly disease, so no big deal". I can't even imagine having to live with that on my conscience. Why would you even take that slight risk if there's a simple treatment for it out there?

I have to agree with GreenShirt. If you're interested in becoming a doctor and you're in it for the right reasons, why would you take a chance of transmitting a potentially deadly disease to loved ones and patients? You speak of a 10% chance as if it's nothing but that's a HUGE percentage. This isn't 1 in 100,000 we're talking about. It's 1 in 10! Take the drugs for your health, for your family, for the public's good.

 

[nimbusadjust120]

I had to take the TB test a couple of weeks ago and I tested positive. Then I took a chest x-ray and after examining the x-ray, my doctor told me that I had latent TB; i.e. I don’t have TB, I just have TB bacteria in my body. He also told me that 1/3 of the world‘s population has a latent TB infection. I suspect I could have caught the disease while traveling with my parents. The doctor told me I could take medication for a year but I don’t want to risk my GPA next year because of the medication’s sideeffects. If I’m not wrong, volunteering at any hospital requires a TB test. From now on, I will always test positive for a TB test. Will a hospital reject me if I asked to volunteer and I test positive for the TB test? Or will they require a chest x-ray to determine if I actually have TB? Furthermore, I think this can cause problems with my application to medical schools. Can a medical school refuse to allow me to attend if I test positive? No jokes please, this is a serious issue.

Be obedient, ok!!! Take your medications regularly to fight off the TB germs. Wait till the germs become dominant in your body, and no amounts of medications are able to fight it, then you are in deep trouble!! Your health is much more important than your GPA. You can put that down on your PS. Med school adcom will understand. Eat the medicines. It is not going to make you jaundice..!

 

[Instatewaiter]

Check with the individual hospitals. Most hospitals ask for a TB test to be done while some don't. Also, don't ask them really but just apply to different hospitals and see which one takes you. I don'y know how serious your issue is. Perhaps, even if your TB test comes back positive (which it probably will) then you can try to explain your situation to the hospital itself.

Institution dependent.

Mine requires PPD/CXR/something every year, regardless.

Once you test positive w/ PPD you wont ever have to do it again- it would be pointless. You are always going to test positive.

I dont think they make you take A CXR every year. At least those I know with the BCG vaccine take one every 3 years.

For this year, you probably won't be able to volunteer in a hospital unless your TB is non-cantagious. Even then, some hospitals won't let you volunteer due to their policies. If so, do something else. Volunteer in a nursing home or do research, whatever you want. You can volunteer at a hospital next year and if worse comes to worse, your physician can sign off saying that your TB is no longer an issue.

Latent TB is not contagious. That said, you can convert to active TB and become contagious.

He doesn't OMG HAVE TB!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

He popped positive because he's got the bugs. The same way we all have gut bugs and people who've been hanging out with kids with mono get EBV antibodies.

No he has TB, just not active TB. It is not only antibodies that he is carrying.

OP you take the 9 mo of INH. Your GPA is not going to drop. Are you willing to sacrifice your health because you are afraid of some side effects? You are in college, relax.

OP-I'm in the same boat as you are and refused to take the meds. The possible side effects are a little to many and even my health care provider did not put any pressure on me to take the meds. She gave me a bunch of publications to read about it and when I came back with a "NO" she completely understood.

Assuming you stay healthy and don't become HIV positive, there is only a 10% lifetime chance that the latent infection will be reactivated. If you become immunocompromised for any reason(esp CD4 cell loss), then the odds change from a 10% lifetime chance to a 10% annual chance of you getting the reactivated infection (I got this data from an infectious disease talk and can't send you anywhere for a reference so take it as you will)

Personally I think this is a very immature and selfish attitude. You should be ashamed of yourself- especially as a medical student. If you activate as a third year you are probably going to infect a couple dozen patients if not more. Given the state of most pt in university hospitals, you could very easily kill someone. Sack up and take the INH

 

[PlayMeSomeMusic]

So I haven't really read the responses.. except the last couple.. and some at first..

First off, I'd like to ask why the medicine takes a year? I had this happen to me too. Positive arm test and negative chest xray. The doctor recommended 6 months of the treatment.

BUT this is what I want to say to everyone who's raging on you cause you don't want to take it.. I decided not to take it either.. and this is why. 1. you can't drink any alcohol and when I got the TB test it was right after my 21st birthday so I'm sorry if ya'll think it's selfish but I was not giving up what I just got for 6 months (and I was graduating imagine the celebrating).. However, the doctor also said that the medicine is ONLY ONLY ONLY must I say it again ONLY good for the current TB exposure.. So while you're not contagious and say you give rid of this strand.. If you're in the hospital working again and someone with TB coughs on you.. Guess what you have to do again! Get another round of medication. This could potentially happen every single time you get coughed on by someone with TB. In fact, how would you know which coughers have TB unless of course that's why they are there. So at an extreme.. every time you get coughed on you could be having to take this medication..

Now let me disclaimer this by saying that it is important to make sure you don't become active.. but the doctor I spoke with said it's usually pretty obvious and if you're not certain just go get a chest x-ray..

Probably every new place you start will require the x-ray. and I've heard once a year or so, or simply if you start to show symptoms. I had a letter from my doctor and it just stated about my chest xrays and said it was fine and no hospitals turned me down for volunteering or anything like that..

Regardless.. you have to do what you think is best for you right now.. I know people that took medicine and I know people that didn't and regardless always show up positive and still have to get chest x-rays to say their fine.

 

[mules05]

However, the doctor also said that the medicine is ONLY ONLY ONLY must I say it again ONLY good for the current TB exposure.. So while you're not contagious and say you give rid of this strand.. If you're in the hospital working again and someone with TB coughs on you.. Guess what you have to do again! Get another round of medication. This could potentially happen every single time you get coughed on by someone with TB. In fact, how would you know which coughers have TB unless of course that's why they are there. So at an extreme.. every time you get coughed on you could be having to take this medication.

I don't think you quite get how this works, and if your doctor actually told you to take another course of INH every time you get coughed on, I'd question his or her judgment.

1. Your PPD will be positive for life, whether or not you take the medication, because it measures ONLY antibodies to TB. This is why you'll need chest xrays- to see whether that one strain has reactivated or whether you've been exposed to another strain. Being coughed on by someone, with or without TB, is not grounds for taking INH again if your cxr remains negative.
2. Personally, I get a flu shot every year- not because I'm worried about the chances of getting the flu myself, but because if I did I'd spread it to my patients. Similarly, if I ever had my ppd convert to positive, I'd take the INH for the same reason.

 

[bola]

Personally I think this is a very immature and selfish attitude. You should be ashamed of yourself- especially as a medical student. If you activate as a third year you are probably going to infect a couple dozen patients if not more. Given the state of most pt in university hospitals, you could very easily kill someone. Sack up and take the INH

I really find it amazing that someone I don't know will make snap judgments about my maturity and altruism based on objective data I presented and a decision I made with my health care provider about what was best in my situation.

 

[LikeClockWork]

I really find it amazing that someone I don't know will make snap judgments about my maturity and altruism based on objective data I presented and a decision I made with my health care provider about what was best in my situation.

Hey, Burnett's Law. It's an exact science.

 

[Monica Lewinsky]

First off, I'd like to ask why the medicine takes a year?

Because in cases of latent infection, the TB is hiding in granulomas in your lungs. These are slowly dividing rods which are "conveniently" hiding in these granulomas, ironically being protected from exposure to the TB cocktail, making it take on the order of months to clear the infection rather than days or weeks like most other pathogenic bacteria.

 

[endocardium]

Because in cases of latent infection, the TB is hiding in granulomas in your lungs. These are slowly dividing rods which are "conveniently" hiding in these granulomas, ironically being protected from exposure to the TB cocktail, making it take on the order of months to clear the infection rather than days or weeks like most other pathogenic bacteria.

Nice. I think what you said is part of the equation. However, also consider that INH is going to be bacteriostatic for LTBI. It's a longer regimen for that reason as well, as far as I know. The CDC report that I am looking at now also says that Rifampin can be used as prophylaxis for LBTI as well, and it has a shorter treatment course (4 months). Rif, I think, is bacteriocidal. Ask your PCP, or ID specialist, about using Rif, if you think 9 months of INH are too much for you. It might be possible to make the treatment course shorter. Either way, it is a very good idea to undergo treatment for LTBI if you are under 35 (according to what I have read). Why take unnecessary risks?

 

[Monica Lewinsky]

Nice. I think what you said is part of the equation. However, also consider that INH is going to be bacteriostatic for LTBI. It's a longer regimen for that reason as well, as far as I know. The CDC report that I am looking at now also says that Rifampin can be used as prophylaxis for LBTI as well, and it has a shorter treatment course (4 months). Rif, I think, is bacteriocidal. Ask your PCP, or ID specialist, about using Rif, if you think 9 months of INH are too much for you. It might be possible to make the treatment course shorter. Either way, it is a very good idea to undergo treatment for LTBI if you are under 35 (according to what I have read). Why take unnecessary risks?

Its also good to do it if you are under 35 since older patients have a higher likelihood of having nastier liver toxicities.

 

[smq123]

BUT this is what I want to say to everyone who's raging on you cause you don't want to take it.. I decided not to take it either.. and this is why. 1. you can't drink any alcohol and when I got the TB test it was right after my 21st birthday so I'm sorry if ya'll think it's selfish but I was not giving up what I just got for 6 months (and I was graduating imagine the celebrating)..

You decided...not to get treatment...just because of...alcohol?!

Oh. I see.

Actually, I don't. That doesn't make a lot of sense to me.

Presumably, your 21st birthday has come and gone...and drinking legally is no longer a novelty...so why don't you go and get treated now?

 

[Team Zissou]

The treatments will remove latent TB, but there will always be drug resistant latent TB that can never be erradicated...

 

[Depakote]

Please limit your responses to the scope of the OP's medical school applications and refrain from providing advice regarding medication which would be best handled by his or her healthcare professional.

REMINDER: This is an admissions discussion. Not a medication or treatment discussion. I do not want to have to close this thread.

Please refrain from telling the OP to do X regarding treatment.
The medical pros and cons of treatment should be irrelevant to this discussion.

All health issues should be deferred to the OP's healthcare provider. We're only allowed to discuss the medical school admissions aspect of his situation.

Thanks.