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Old 02-05-2008, 09:17 AM   #1
runnerr
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TB Test

Hello, just curious but has anyone ever had a positive reading on a TB test. And if so what procedures did you follow.

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Old 02-05-2008, 09:29 AM   #2
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A positive skin test indicates past exposure. It can occur with no evident disease, or with active disease; BCG vaccine is used in some other countries and can also cause a "false" positive for several years after vaccination. By itself, a positive skin test is not a panic situation.

Depending on your age, chest x-ray, and the context in which it was ordered it can be observed only, treated with months of antibiotics to root out any hidden infection thus preventing active disease in the future, or receive full blown treatment. Preventive antibiotics are a tradeoff decision, since the older you get the more likely the common drugs are to cause liver inflammation.

Hope that helps.
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Old 02-05-2008, 09:44 AM   #3
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DW had a positive test. Chest Xray and 6 months antibiotics. I guess nothing came of it - she's fine now. Probably came from growing up in a 3rd world country. She was sick a lot as a young kid.
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Old 02-05-2008, 09:52 AM   #4
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Thanks, I just needed a little peace of mind as I see the doctor tody after having the chest x-ray yeaterday. Mu age is 59 and I don't drink so I think I will go with the meds for 6 months to a year. thanks again.

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Old 02-05-2008, 10:16 AM   #5
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Rich, I had a positive test in High School and the local Dr. told me to never have another skin test. (Might activate the tubercle?) I've had some serious arguments over the years to follow this advice (think standing in line getting my military service shots/etc.). So now, 40 years later, do you think this is necessary?

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Old 02-05-2008, 12:59 PM   #6
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Quote:
Originally Posted by TeeRuh View Post
Rich, I had a positive test in High School and the local Dr. told me to never have another skin test. (Might activate the tubercle?) I've had some serious arguments over the years to follow this advice (think standing in line getting my military service shots/etc.). So now, 40 years later, do you think this is necessary?
Once positive you are always positive, theoretically (not so during certain types of acute illness, though). That's why no need to repeat.
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Old 02-05-2008, 01:05 PM   #7
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I have another question. If you test positive and take the drug INH for 6 months to a year to take care of it but there after cannot have another TB test how do you know if you are ever re infected from a different source and get TB again?

thanks,

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Old 02-05-2008, 01:40 PM   #8
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Originally Posted by runnerr View Post
I have another question. If you test positive and take the drug INH for 6 months to a year to take care of it but there after cannot have another TB test how do you know if you are ever re infected from a different source and get TB again?
Most clinical tuberculosis is from reactivation of initial infection that went unnoticed for years or even decades. Once you've had INH, that risk is greatly diminished (your PPD stays positive).

While there is a theoretic possibility of a new, primary exposure it is very unlikely. First, in N. America, you are not likely to be secondarily exposed unless you are in a high risk situation. Second, you have some immunity from your first go-around which makes reinfection very uncommon.

The only such secondary cases I've seen are in people who are taking steroids like prednisone or cortisone (as well as chemo and the like), or who have AIDS, and reactivate because of immune suppression.

Bottom line: if you have 6 months of INH for a positive skin test only, you are very unlikely to ever have to worry about recurrent TB.
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Old 02-08-2008, 10:03 AM   #9
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There is some concern over the incidence of MDR (multi-drug resistant) TB entering the country via immigrants (legal and illegal) - several papers have been published about this growing threat. Approx. 50% of pulmonary TB cases in this country are from foreign-born individuals.

Some good info here:
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Old 02-09-2008, 11:22 AM   #10
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In 1966, after standing in line with thousands of other University of Hawaii freshmen, I got my required TB skin test. The results were equivocal - - I think there were four levels with "1" being no TB, and "4" being TB, and I had a "2". I was horrified but was told to do nothing about it and that it was not a problem.

Anyway, I dutifully did nothing. Fast forward 18 years.... my next TB test came out completely clean, without question, and I definitely do not have TB. All I can think is that the "slightly positive" result was not really TB at all.
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Old 02-09-2008, 02:00 PM   #11
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DW had a positive test in 1966 age 11 where we all were tested prior to getting the BCG innoculation. Her Godmother, an aunt got TB and as a baby she had been innoculated as a precaution but they still whisked her off for a chest X-Ray to be sure she was clear. At 11 she didn't need the BCG.

We were both tested for TB in 1998 during our medical for citizenship application and both tested positive. Fortunately the doctor was aware of the practice of BCG innoculations in England so we didn't have to produce any proof or go for an X-Ray.
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