Positive ppd test

Flare, ASN, BSN · Jan 6, 2009

BabyLady said:
A skin test nor a chest x-ray diagnoses TB. Sputum samples as well as a biopsy is what would be needed.
No way are they going to prescribe you any meds (which most people have to take from six months to a year if they do have TB) based on a skin test and x-ray...positive or not.

When I had my + ppd (and neg cxr) I was pretty much told that i had to take the Isoniazid therapy. This also came with monthly visits to my county's TB clinic. So I took the meds and trekked to the clinic every month for 9 months. I suppose I could have opted out of the meds, but honestly, i didn't think of it at the time.

SaraO'Hara · Jan 6, 2009

Same experience here... but I got through LVN school. Just had to show the + test result report and negative CXR report with my application.

sicushells, RN · Jan 6, 2009

NewRN2008 said:
Nobody here can answer your question exactly because we cannot give advice.
BUT, I know there have been many ppl that have had a false positive for various reasons. I know I did because I had so many of them dang darn things in nsg school I started having reactions to the tb injection. so unless you are 100% + ur are positive, do some research and inform yourself.

Me too. I was referred to an infection control MD specialist, who basically laughed that I was even there. I would try not to worry too much until you know more.

Not_A_Hat_Person, RN · Jan 7, 2009

debi49 said:
Standard follow up to positive ppd is Chest xray. Positive PPD does not mean you have tb.

When I was 9, I got a bad rash the day after I got my PPD. They weren't positive the 2 weren't related, so I had a chest x-ray, which came back negative.

I had some Eastern European and African classmates who got the TB vaccine. The vaccine isn't used in the US, but it causes a positive PPD.

GooeyRN, ADN, BSN, CNA, LPN, RN · Jan 7, 2009

BabyLady said:
A skin test nor a chest x-ray diagnoses TB. Sputum samples as well as a biopsy is what would be needed.
No way are they going to prescribe you any meds (which most people have to take from six months to a year if they do have TB) based on a skin test and x-ray...positive or not.

I was prescribed 9 months of INH for a positive PPD and a negative x-ray... This was in 2001. I was never asked for a sputum sample. I had no cough or signs/symptoms of tb or anything.

vamedic4, EMT-P · Jan 7, 2009

BabyLady said:
A skin test nor a chest x-ray diagnoses TB. Sputum samples as well as a biopsy is what would be needed.
No way are they going to prescribe you any meds (which most people have to take from six months to a year if they do have TB) based on a skin test and x-ray...positive or not.

This is incorrect. When I was a student medic years ago that's exactly what they did, and from what I've heard, still do. I had a false positive which was barely noticeable until the nurse scraped my arm with her key. Then the site blew up like a balloon. I was on INH and the vitamin supplement for 6 months, with CXR and labs done too.

I have never tested positive since. Oh, and when they tell you not to drink alcohol while on INH...they mean it. Trust me.

SunnySweetpea · May 30, 2009

Hi! I just had a positive TB test today and am waiting on chest x-ray results. They want me to start on 9 months of INF, but before I do that, I want to double check the results. I have sensitive skin that reacts to everything and I get hives easily. On 2 past occasions, I've had a positive read, done the 2 step method and had a negative read on the re-do. My new employers refuse the 2 step method. I want to get the blood test, Quantiferon TB Gold, but my primary physician refuses to order it because she doesn't feel it's necessary and the doctor that read my test is no help either. Has anyone heard of this test or do you have any advice? I would accept a blood test if it said I was positive and take the potentially liver damaging meds for 9 months, but I don't trust my skin test especially because it was red, not raised, and the MD refused to feel the skin to make sure, he had the other doctor (the director) feel it and confirm, but that was after the first doctor talked to him, so I'm not too sure. Also, I had a TB 2 step 2 months previous (first was positive, second negative), so how do I know it's not a reaction to that? (Sadly, the there's a 60 day limit on TB tests that they accept and I was a week past, so they refused to accept the previous test).

regularRN · May 30, 2009

Before anyone with a positive PPD embarks on a course of treatment - if you are from overseas, chances are you were vaccinated against TB with the BCG. The BCG gives a positive PPD because - of course - it stimulates antibodies against the bacteria. A chest x-ray will establish that there is no active disease process.

KateRN1 · May 30, 2009

prenurstudent said:
I am so afraid becuase I think I won't be able to find a job in the future if I test positive.

Don't worry about it. I've been positive since 1983 and it hasn't hindered my career in the least. I took INH for 14 months after the positive and have had negative chest x-rays all along. No one has ever even suggested that it might hurt my chance for a job.

Oz2 · May 30, 2009

SunnySweetpea said:
I want to get the blood test, Quantiferon TB Gold, but my primary physician refuses to order it because she doesn't feel it's necessary and the doctor that read my test is no help either. Has anyone heard of this test or do you have any advice?

Sunny, where I live, if you have a positive TB test, you can go to the health department to get a chest x-ray or the blood test (they gave me my choice). It's likely the Health Department in your state is the same, instead of depending on a physician to order it for you (how annoying!) I got the blood test and I think it cost about $40.

Home Health Columnist / Guide · May 30, 2009

Medlineplus Medical Encyclopedia: PPD skin test

Interpreting a ppd test you are not looking at redness @ the site but a raised hard induration/swelling that needs to be measured.

The positive response to ppd antigen is seen here. the size of the swelling is over 2 cm in diameter. (Talking about inner raised section between lines)

Do not measure the redness area, only raised swelling area.

Medlineplus Medical Encyclopedia: PPD skin test

Quote
What abnormal results mean
The results of the test depend on the size of the skin reaction and on the person being tested.
A small reaction (5 mm of hard swelling at the site) is considered to be positive in people:
who have hiv
who are taking steroid therapy
who have been in close contact with a person who has active tuberculosis
Larger reactions (greater than or equal to 10 mm) are considered positive in:
people with diabetes or kidney failure
health care workers
In people with no known risks for tuberculosis, a positive reaction requires 15 mm or more of hard swelling at the site.

A positive skin test does not necessarily mean that a person has active tuberculosis. more tests will be done to check whether there is active disease, most often follow-up is cxr or possibly sputum specimen.

CDC: Questions and answers about tb.

Please ask for second opinion re site measurement from a supervisor @ testing site or discuss with your pcp for your specific situation.

ngocthong · Aug 9, 2010

mom2michael said:
A positive PPD test means you've been exposed to TB, doesn't mean you have it. A chest X-ray will probably be the next thing and then they'll go from there. A co-worker of mine tests positive every time we do ours, she has her Xray to make sure it hasn't progressed since the last time she had one and all is good. She has tested positive for the last 15 or so years she said and her X-rays always look the same.

Hi Michael

I 'm test ppd positive, but my X-ray look good.

Do I have to take any medicine to stop ?

Thanks you

Ngocthong