Positive PPD test after BCG vaccine

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    Hi, I am a senior year BSN student. I am from India. I don't how old I was but I had a BCG vaccine when I was little. until now, I always had negative PPD test. Last week I had my TB test and came back positive. I have already scheduled my chest Xray. but now I am little concern. Last two PPD test I had from health department and for this one, I went to little clinic @ kroger. The lady who read my TB test, she told me you always test positive after your BCG vaccine. Now I am confused. Do I still have to do two step TB test?
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  5. 1
    As I understand it, yes you will always get a +PPD after being vaccinated with BCG. What I have been told is that you should not even have a PPD after the BCG and a + result, go directly to CXRAY. Your program should have a policy for a + test, but I would guess the two step will not serve any purpose. I know a nurse who has been doing this for a good many years and she says this happens more often than you would think.
    BluegrassRN likes this.
  6. 0
    Thanks for your reply.
  7. 1
    You will always have a positive PPD if you received the BCG vaccine. I actually have several relatives from Poland (including my mother!) who all got that vaccine. Two of my relatives work in a hospital and they ALWAYS get a bad reaction from the PDD test. I don't know why they always make them get the PPD every year instead of just going straight for a CXR or sputum culture. In the future, tell your them you had the BCG vaccine and request a CXR or sputum culture instead.
    BluegrassRN likes this.
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    Thank you so much. I am a new member at this site. I just post my question yesterday night . I already got two reply. I am so impress with this. Again thank u so much.
  9. 0
    sorry, the answers you have been given are incorrect.

    history of bcg vaccination is not a reason to forgo ppd, and there is not always automatic positive result with remote bcg vaccine. anything 10 mm induration or less, is not to be considered positive. if you then have what is read as a positive measurement, then you need an cxr.

    look at the american thoracic society's position and the cdc for recommended protocols. the quantiferon-tb gold test is also used to screen these patients as there is no cross reactivity with bcg.

    just because one " has done something for a long time" doesn't mean they are [color=#1122cc]knowledgeable.


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