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- Oct 10, '05 by TiffyRNI used to have a positive PPD due to BCG inoculation as a child so I didn't get the PPD for many years. Then they determined I shouldln't be reactive anymore, so I had the PPD last year and was negative. I just had my annual PPD done about a month ago and my story sound identical to the OP's. Starting itching and swelling a few hours after the test. The spot was raised and indurated for about 15mm, and very pink and itchy when I went back for the recheck. The employee health nurse examined it, ran a pen over it determining there was no clear margin of the induration (I guess that's important) and declared I didn't have a positive PPD but probably had a reaction to the nickel (preservative) in the PPD solution. She asked did I react to cheap earrings (I do) and then cleared me to go back to work. I just figured I was positive again due to my childhood BCG inoculation but didn't understand no reaction last year. Maybe the PPD solution last year was a different kind/brand and didn't have nickel?
My dilemma is I want to refuse further PPD's as the spot is still itchy, red and flaky a month later. I want to declare an allergy to nickel and refuse further PPD's in the future. They can xray me, or give me the check-off question list like they did for years when they thought I was positive.
I work in a very low risk environment (neonatal ICU) and feel I am at no greater risk to contract TB than if I had a non-healthcare related job. Yes I know some random visitor or parent MIGHT have it but generally the moms at least have had some pre-natal care and we screen for fevers/coughs before allowing visitors back.
- Oct 10, '05 by HauntedWAIT!!! I am confused. If you test positive and have a CRX you no longer have to take the PPD??? Topical (excuse the pun) subject since my registry from a HOT PLACE just sent me back to the stinky occupational medicine clinic today to retake a PPD.
I had it done last week on one of my many days off and it was negative. So imagine my surprise when I got a call from the stinky clinic telling me I needed to repeat the test!
WELL!!! After I was approved for a second on my mortgage, I was able to sprinkle some gas in my car and head off to the stinky clinic to sit amongst longshoremen, concrete pumpers and off shore oilriggers who have not been intimate with a bar of soap since the REAGAN administration to finally be called into the exam room for another heaping dose of attenuated TB into my tender loving arm.
All these things we go through, some days I really ponder whether I would just do better as a Super Model or spokesperson for DAMM
- Oct 10, '05 by strssedstudentI had the same reaction a couple of years ago when I started CNA class - it got so big (almost 1 1/2 inches) that I called the clinic. They had me come in at 48 hrs instead of 72. It was an allergic reaction to the shot itself. The way the nurse explained it to me - a positive TB test will have a small fluid filled blister (not sure about this but that's what I was told). I had to get another one this year when I started RN school - and had no reaction to it this time!!!!
- Oct 10, '05 by TweetyQuote from HauntedWAIT!!! I am confused. If you test positive and have a CRX you no longer have to take the PPD???
Yes. Usually once you test positive, you will always test positive, so no need to be tested year after year. Some places require a yearly chest xray, other places make you sign a statement yearly that you have none of the symptoms, and list the symptoms. But no yearly ppd once you test positive.
- Oct 11, '05 by BittyBabyGrowerThat is an allergic reaction to the thirmasol....your next PPD should be the preservative free one....I have that reaction to anything with thirmasol.
- Oct 11, '05 by boomerfriendI'm a pre-nursing student in Pathophysiology this semester. We just covered TB. The instructor said that the induration must be raised and not necessarily red, and at least 15 mm. That's a big spot! Itching was insignificant. Also, she said that that just indicates exposure and must be confirmed with a sputum culture (although a CXR will be done first).
Just figured ya'll would like to know what they're teaching us newbies....