Positive Quantiferon test for TB

[Volkmann]

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I tested positive for TB in the pre residency physical. It's the quantiferon test. Can anyone tell me what happens if the chest X ray is negative and what happens if it is positive (ie active TB). Would I not be allowed to start my residency?? Thanks.

 

[Raryn]

I tested positive for TB in the pre residency physical. It's the quantiferon test. Can anyone tell me what happens if the chest X ray is negative and what happens if it is positive (ie active TB). Would I not be allowed to start my residency?? Thanks.

CXR negative you'll likely need to undergo treatment for latent TB.

CXR positive, I assume they won't let you start until you're ruled out for actual active pulmonary TB. That would mean 3x afb sputums at least 8 hours apart. Then you'd have to either go on treatment for active or latent TB depending on which you had.

 

[chessknt]

Whoops. Agree with above now after reading about it while more awake.

 

[HelpPleaseMD]

bcg does not interact with quantiferon

 

[Crayola227]

bcg does not interact with quantiferon

1/2 the point of doing a more expensive quantiferon. other indication is for immunosuppressed patients who might not otherwise be able to mount a positive on skin testing.

 

[Crayola227]

CXR negative you'll likely need to undergo treatment for latent TB.

CXR positive, I assume they won't let you start until you're ruled out for actual active pulmonary TB. That would mean 3x afb sputums at least 8 hours apart. Then you'd have to either go on treatment for active or latent TB depending on which you had.

I'm with Raryn. I'd say there's a 99.9% chance that the residency program is NOT going to allow something like this to prevent you from doing your residency there.

There will be hoops and perhaps even starting late (depends, from what I remember the injunction to not be around anyone is not for all that many days into your antibiotics (just what I remember vaguely writing on some dc paperwork for a coughing-up-blood TB'er after talking to the state health department)). But what's OK for gen pop is not always OK for docs.

Those antibiotics suck.

Take them correctly. I know of a med student who goofed up their doses like twice and it resulted in them having to take them for like 2x as long, like 10 months. Don't ask me. This is hearsay aside from the fact that you need to take taking any antibiotic regimen they give you very seriously.

 

[Raryn]

I'm with Raryn. I'd say there's a 99.9% chance that the residency program is NOT going to allow something like this to prevent you from doing your residency there.

There will be hoops and perhaps even starting late (depends, from what I remember the injunction to not be around anyone is not for all that many days into your antibiotics (just what I remember vaguely writing on some dc paperwork for a coughing-up-blood TB'er after talking to the state health department)). But what's OK for gen pop is not always OK for docs.

Those antibiotics suck.

Take them correctly. I know of a med student who goofed up their doses like twice and it resulted in them having to take them for like 2x as long, like 10 months. Don't ask me. This is hearsay aside from the fact that you need to take taking any antibiotic regimen they give you very seriously.

Any time isolated from people depends on active vs latent.

Obviously, latent TB, regardless of what the cxr shows, you can see people whenever. Active TB, you're basically isolated in a negative-pressure hospital room until you've been on treatment long enough that you have 3 negative AFB stains. Normally takes about a week. Some people might be stuck in the hospital for >1 month waiting to become noninfectious (seen it a couple times in residency). The remaining months of treatment after your sputums turn negative, you are not infectious and can go out in public as per normal.

Even with active TB, there's a theoretical possibility that they could send you home to isolate yourself if you are a responsible person and there's no one else in your house who can get TB... but I've never seen the health department even consider that option. Your locality might vary I suppose.

 

[IMreshopeful]

I have seen patients do TB rule outs from home because they were responsible people. It makes more sense to me for the right person as opposed to hospitalizing them.