Worried about PPD Results

  1. Hi. I just was tested twice for TB by a PPD shot in the forearm and both times it turned into a red, slightly raised spot about the size of a quarter. Now I have to get a chest x-ray. I'm perfectly healthy and I've never had a disease or anything wrong with me nor have I been out of the country or anywhere funky.
    How on Earth could I be positive for TB!?
    If I quit my perfectly wonderful job for this one and then I cannot work here or as a nurse in the future I'm going to be so upset. I hope I'm just getting all worked up because of nothing.
    The nurses who evaluated my test said I could be allergic to the serum or proteins in the shot. I hope that's the case and I just get a really cool picture of my insides to keep.
    Has anyone had any problems like this before?
    I need some support.

    Shel
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  2. 16 Comments

  3. by   ktwlpn
    Quote from shel_wny
    Hi. I just was tested twice for TB by a PPD shot in the forearm and both times it turned into a red, slightly raised spot about the size of a quarter. Now I have to get a chest x-ray. I'm perfectly healthy and I've never had a disease or anything wrong with me nor have I been out of the country or anywhere funky.
    How on Earth could I be positive for TB!?
    If I quit my perfectly wonderful job for this one and then I cannot work here or as a nurse in the future I'm going to be so upset. I hope I'm just getting all worked up because of nothing.
    The nurses who evaluated my test said I could be allergic to the serum or proteins in the shot. I hope that's the case and I just get a really cool picture of my insides to keep.
    Has anyone had any problems like this before?
    I need some support.

    Shel
    To be a true positive you have to have an area of at least 10cm of induration-a swollen area...(how darn big is a quarter?) After the first reaction they should have sent you for an x-ray-they NEVER should have administered another PPD due to the risk of severe damage to the area.(remind them of that fact).You can have a reaction like this just because you have been exposed to it at some point.It is prevalent in the US and all socio-economic groups are affected.It does not mean you did anything wrong....And if you ARE positive you'll be treated and you'll be fine...It will have no effect on your career-other then no PPDs ever-always a chest x-ray....Good luck
  4. by   shel_wny
    Quote from ktwlpn
    how darn big is a quarter?)
    Eep! I take for granted everyone being from the United States and knowing what the coin called a quarter is. :imbar
    A quarter is a circle of about 3 cm in diameter.
    I hope that makes more sense to you. Sorry!

    Shel
  5. by   ktwlpn
    Quote from shel_wny
    Eep! I take for granted everyone being from the United States and knowing what the coin called a quarter is. :imbar
    A quarter is a circle of about 3 cm in diameter.
    I hope that makes more sense to you. Sorry!

    Shel
    You silly! -I was joking..I don't think you really need to worry-I was just trying to lighten the mood.....
  6. by   shel_wny
    Quote from ktwlpn
    You silly! -I was joking..I don't think you really need to worry-I was just trying to lighten the mood.....
    You are SO evil. :chuckle
    And yes, you made me smile so it worked!
    Thanks!

    Shel
  7. by   elkpark
    A + Mantoux test doesn't mean that you have TB, it just means you've been exposed and your body has created antibodies. A chest X-ray is routine for a new +, but the chance that you have active TB is so slim that it's not worth thinking about (assuming that, as you say, you have no sxs).

    As ktwlpn noted, you should not allow anyone else to give you a Mantoux test from now on! You can react severely and suffer serious injury at the test site. The results would always be positive anyway, so there is no point.

    As for "how on earth" you could be positive for TB, it's everywhere -- I've heard public health experts say that everyone who lives in or has visited a major city has been exposed ... It's just a matter of whether you have been exposed "enough" to trigger your immune system to develop antibodies (which is what the Mantoux tests for, not the presence of the TB bug). Has nothing to do with socioeconomic status, personal hygiene, or cleanliness or otherwise of living conditions. Fortunately, the TB bug is a fairly weak, opportunistic beastie that can only produce active disease in people who are poorly nourished, seriously "run down," or otherwise immunosuppressed.

    TB is a "reportable" disease, though, and you will have to report to your local public health department for evaluation and recommendations. You may well be required to take the prophylactic medication therapy (INH or one of the others) to wipe out any TB that may be lurking inside you. I went through this in nursing school -- + Mantoux after a history of - results, immediate CXR (in my case, the radiologist saw a "shadow" in my lung and I also had to have a fluoroscopy to rule out active lesions -- v. scary couple days ...), had to "turn myself in" to the public health department and do a year of prophylactic INH therapy. It all turned out fine.

    Having a + Mantoux test will not affect your employability in nursing -- I've been + for close to 25 years now, and it's never been an issue with a job. Lots of people are +, and it's no big deal.
  8. by   suzanne4
    Quote from ktwlpn
    To be a true positive you have to have an area of at least 10cm of induration-a swollen area...(how darn big is a quarter?) After the first reaction they should have sent you for an x-ray-they NEVER should have administered another PPD due to the risk of severe damage to the area.(remind them of that fact).You can have a reaction like this just because you have been exposed to it at some point.It is prevalent in the US and all socio-economic groups are affected.It does not mean you did anything wrong....And if you ARE positive you'll be treated and you'll be fine...It will have no effect on your career-other then no PPDs ever-always a chest x-ray....Good luck
    10 mm not cm
    10 cm is equal to 4 inches
  9. by   Katnip
    I know quite a few nurses who test pos. for Tb. Some got exposure on the job, some come from countries where it's a given they're going to test pos.

    The disease itself is curable also.

    This is not something that will keep anyone out of healthcare.
  10. by   rnmi2004
    It is my understanding that if you have a +Mantoux, you will have to prove your -TB status by having a CXR q3 years. Is my understanding correct? I've always thought that aspect of it would be kind of nice--that yearly skin test really sneaks up on you. We had a student in our 1st semester who was unable to finish the semester because she waited too long for her skin test--turns out it was positive and by the time she could get in for a CXR her year was up. They wouldn't let her return to clinic.

    For those who have had the prophylactic INH (or other TB drug) tx--how did your body tolerate it? How often did you have to have liver function studies done?
  11. by   vmburg
    Quote from shel_wny
    Hi. I just was tested twice for TB by a PPD shot in the forearm and both times it turned into a red, slightly raised spot about the size of a quarter. Now I have to get a chest x-ray. I'm perfectly healthy and I've never had a disease or anything wrong with me nor have I been out of the country or anywhere funky.
    How on Earth could I be positive for TB!?
    If I quit my perfectly wonderful job for this one and then I cannot work here or as a nurse in the future I'm going to be so upset. I hope I'm just getting all worked up because of nothing.
    The nurses who evaluated my test said I could be allergic to the serum or proteins in the shot. I hope that's the case and I just get a really cool picture of my insides to keep.
    Has anyone had any problems like this before?
    I need some support.

    Shel
    You shouldn't have had the second PPD. Cxray should have been obtain when the redness with induration occurred. I am allergic to Tubersol. Turns red, no induration and intense itching. I have been tested with 5TU and 2TU same results. I have CXray every 2 years .
  12. by   longtermcarern
    Quote from rnmi2004
    It is my understanding that if you have a +Mantoux, you will have to prove your -TB status by having a CXR q3 years. Is my understanding correct? I've always thought that aspect of it would be kind of nice--that yearly skin test really sneaks up on you. We had a student in our 1st semester who was unable to finish the semester because she waited too long for her skin test--turns out it was positive and by the time she could get in for a CXR her year was up. They wouldn't let her return to clinic.

    For those who have had the prophylactic INH (or other TB drug) tx--how did your body tolerate it? How often did you have to have liver function studies done?
    I took the INH for just over 4 months and then developed an allergic reaction to it. Broke out it hives all over every morning 1/2 hour after taking it and they would go away only 1 to 2 hours before the next dose was due. After 3 miserable weeks the health department said I didn't have to take it anymore. I also had elevated liver enzymes for about 8 years after taking it but they are finally back to normal.
  13. by   adidas99
    .....
    Last edit by adidas99 on Jan 29, '07
  14. by   elkpark
    that one good way to know is, where the site is, take a pen and draw it towards the site. if it stops because of the bump, try from the other side...and if the bump stops the pen mark, then it's a positive TB test. that settled our minds versus the redness mark and stuff...
    Reading a Mantoux test has nothing to do with redness, it's the size of the raised area (if there is one) at the site. I was taught to "read" the test with my eyes closed -- you are more sensitive to what your fingertips are feeling, and you don't get distracted by the appearance of the site.

    I took INH for the full year, didn't have any problems, I think they checked my enzymes a couple times during the year (but also questioned me for any liver sxs each month at my clinic visit).

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