Positive TB Test.

[predodoc]

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I am planning to attend a DO school in August. I went to get my physical done and my TB skin test came back positive. They want to give me another test then a chest X-ray. Since Im not sick right now they said I probably have the latent infection and only have a slight chance of ever getting it, but may start me on a 9 month long treatment of Isoniazid. Do you think the school is going to have a problem letting me start??thanks.

 

[predodoc]

sorry about the other thread, my internet went down while I was in the middle of posting it.

 

[EastCoaster78]

Have you ever had a BCG vaccine? This could give you a false positive. My girlfriend has had one before and tested positive. Her physician put her isoniazid to make sure there was no infection, and they just documented it and allowed her to start school. Call your schools student health office. They'll be able to give you their policy.

 

[jnpeacoc]

Do you live in/near a rural area? Because I had a positive TB test rxn a year and a half ago, and after multiple meetings with a cardiologist to analyze my chest x-rays, he decided that it was most likely a false positive that can be caused by exposure to pigeon droppings. After long consideration, he decided NOT to put me on the preventative medications due to the severity of possible side effects and because he was nearly certain that I had not been exposed to TB, but this was our specific decision, it should not apply to all TB tests.

And I'm sure that as long as you don't have an active case and take the necessary precautions, any school should be fine with it. All hospitals I have ever worked in have a policy for what steps are necessary if a TB test is positive, and it usually consists of a chest xray, and then either preventative medication or a cardiologist's documented decision not to administer the medication.

 

[group_theory]

I would suggest you follow the standard procedure - get a 2nd PPD test (in case the first one is a false positive) - and if it comes back positive, get a CXR to r/o TB and then start on 9 months of INH (or whatever anti-TB cocktail that your doc decides is best)

SUCKS but every hospitals/medical center will require annual TB test. Once you react, you will almost always have a positive reaction to subsequent PPDs. And many/most hospitals have annual PPD requirements. So start the regiment now and have it documented so you won't have to go through this again later in life (beginning of 3rd year, beginning of residency, etc)

I don't think the school will have any problem allowing you to attend/engage in normal activities as long as you're on a treatment protocol.

Healthcare workers have a higher incident of testing positive for TB than most other professions because that's the nature of the job - being exposed to diseases all the time.

 

[lmat27]

I work with a doc who also has had a positive PPD test but has a negative chest X-ray. He was definitely exposed to TB about 5 years ago while he was working with TB patients in Africa. As far as I know he has never had to start the TB treatment regimen since the X-Ray was fine. Plus all our employer needs from him is to have his negative chest X-ray on file.

 

[Dies Irae]

I've read that the HIV virus can also make patients yield positive TSTs.

 

[Belfagor]

I am planning to attend a DO school in August. I went to get my physical done and my TB skin test came back positive. They want to give me another test then a chest X-ray. Since Im not sick right now they said I probably have the latent infection and only have a slight chance of ever getting it, but may start me on a 9 month long treatment of Isoniazid. Do you think the school is going to have a problem letting me start??thanks.

I always test positive for TB. I recommend just getting the chest X ray done instead of a second skin prick. I was told that repeated pricks to someone who gives false positives can cause an abcess. I was exposed because I lived with someone who was exposed. It's really not a big deal, and false positives are a common occurance.

 

[hylacinerea]

I've read that the HIV virus can also make patients yield positive TSTs.

--From the National Lung Health Education Program--

In various studies among HIV-negative adult patients with active pulmonary disease, 15% to 25% of individuals at the time of diagnosis did not have a positive response. As might be expected, patients with HIV infections/AIDS have progressively higher rates of anergy or false negative reactions to the tuberculin test as their CD4-lymphocyte count diminishes. Among persons with HIV infections but no other AIDS-defining illnesses and high numbers of CD4 lymphocytes, the likelihood of a positive skin test is approximately 70%. However, among patients with advanced AIDS and CD4+ T-lymphocyte depletion, as few as 10% to 20% of the patients with tuberculosis may react to the TST.

 

[TPBC]

I've had a positive PPD since the 3rd grade (don't know why) and have since always bypassed subsequent PPDs and elected to have the CXR. Once my doctor suggested I do the INH therapy but I chose not to primarily because of the potential side effects (to the liver). Also, if you are over 35, the side effects outweigh the benefits so it is usually not admininistered to those over 35 (according to my doc). Your school should be satisfied with the negative CXR.