A possitive tb test

Home Health Columnist / Guide · Nov 26, 2014

A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease....
Diagnosis of Latent TB Infection or TB Disease
If a person is found to be infected with TB bacteria, other tests are needed to see if the person has TB disease.
TB disease can be diagnosed by medical history, physical examination, chest x-ray, and other laboratory tests. TB disease is treated by taking several drugs as recommended by a health care provider. ...
Diagnosis of Tuberculosis Disease
Treatment Options for Latent Tuberculosis Infection

If further testing yields positive results, one is prescribed TB medications --after taking them 2-4 weeks, no longer considered contagious and can resume working/being around other persons

MedlinePlus : Taking medicines to treat tuberculosis

RNsRWe, ASN, RN · Nov 26, 2014

I could be wrong, but I'm going to guess you were raised in a country other than the US, correct? If so, you may have received a vaccination (BCG) that would create a positive PPD result. Always. Regardless of your actual TB status. If this is the case, you should never do a PPD...it will always come out positive.

For people who test PPD positive, or have a hx of TB, there is a blood test that can determine if you have had more than just an exposure, if you've actually built up antibodies: a Quantiferon test. No big deal to do.

They will probably do a chest xray, as you mentioned. If the cxr is negative, again, no big deal; it's going to look for an active TB process.

No one on this board is allowed to give medical advice; I am only explaining the procedures used in pre-employment screenings. Once the tests are completed, you will either be cleared as TB-free (but will probably be told you should do annual screenings for symptoms) or you will have a treatment plan recommended to you.

Hang in there. It's a common situation, believe me!

KelRN215, BSN, RN · Nov 27, 2014

A blood test was positive or a PPD was positive?

RNsRWe, ASN, RN · Nov 27, 2014

A blood test was positive or a PPD was positive?

I was unclear on that, too, but I'd be willing to guess it was a PPD.....I place A TON of them and you'd be surprised how many people think I'm doing "a blood test". I have to explain to the majority of them I'm not taking blood, I'm actually injecting protein/antigen under their skin.

I wonder if the OP had a positive PPD, and then was sent for an actual blood test....? Or if I got this totally backward. Oh well, I'm trying! :)

firstinfamily, RN · Nov 27, 2014

A positive PPD may mean you have just been exposed to TB, a CXR will show if it is active or not. You would have to go through treatment if the CXR shows active TB. This would hold up your employment as they cannot have someone caring for sick people who has active TB. RNSRWE mentioned a blood test Quantiferon that I am not familiar with Perhaps this will determine if the TB is active or not. Good Luck!!

libra32 · Nov 27, 2014

the Blood test was positive

CandiceNTexas · Nov 27, 2014

A positive quantiferon is not indicative of active tb, it shows exposure to tb. Most likely your cxr will be fine (if you have no symptoms, ie coughing, night sweats, fatique, weight loss, etc). BUT you may still be prescribed inh forever, not really, 9 months, but it seems like forever, and you will always test positive on the ppd test. I was told I would not have to have a ppd test anymore. This happened to me a couple of years ago, due to exposure at work, and boy was it scary, I ended up having a ct, because of a "shadow" on the xray. It can be a frightening experience, but I didn't lose one day of work. Don't let your fear get the best of you, most likely you will be just fine!

RNsRWe, ASN, RN · Nov 27, 2014

Quantiferon (Quantiferon Gold) is not unlike a titer, in that it will look for a threshold number of antibodies. Speaking simply for the purposes of this thread, if there are enough present to make the test positive, the person tested is EITHER actively ill, OR has been ill in the past. Not everyone who has been ill with TB knows this, as it is (surprisingly) mistaken for a bad chest cold, or a flu based on symptoms...especially if the symptoms pass relatively quickly (in the same time frame as a flu might). It isn't going to be positive for just an exposure without illness of any degree (as can happen with PPD positives), but actually ill.

Thing is, having seen enough Qu+ for me to take an educated guess, I'd say it's not common for the person who is Qu+ to be actively ill, not common to be presenting with s/sx, but certainly further testing would be indicated. And, of course, treatment especially if there ARE any s/sx.

OP, see what the CXR says, or CT if one is ordered for you. Odds are on your side for NOT being barred from employment, but it WILL be delayed until a determination is made as to whether they will require treatment or just annual screening/monitoring.

klone, MSN, RN · Nov 27, 2014

We get quite a few +quantiferons where I work (we will pretty much test anyone who was born outside the US at entry to care). I've never seen a case of active TB, but lots of LTBI. 6-9 months of meds is what's needed. You will always have a + quantiferon, regardless of treatment.

tyvin, BSN, RN · Nov 29, 2014

I live in Hawaii and every other RN I know has inactive TB infection. I do as well and get a chest x-ray every year. You are given an option for medication which is an extensive 6 month therapy or better as previously stated. I chose not to take the meds as it is not required...let me say that again; the medication regime for the inactive TB is not required.

The meds are extremely bad for the liver and since I had contracted HCV from work years prior, though successfully treated, I chose to spare my liver the extra insult. People with a history of HCV are double the risk for developing the disease and half of those develop it in the first 2 years of infection of TB. It's been 8 years and no night sweats and clear chest x-rays still coming.

Around 5% to 10% of persons diagnosed with the infection of TB will develop the disease at some time in their lives.

I'm fine and found out during a recent hospitalization where they did a 2 step that; an induration did not occur at the site, clear as a bell.

I don't know why I told them to go ahead with the 2 step knowing that I had the inactive TB, but the results were confusing. I saw the induration myself at the start of all this years ago and it looked like a picture textbook example of an induration. Now, after 8 years I do a 2 step and it comes out clear! Hmmmm; still going to get the yearly chest x-rays. :)

libra32 · Nov 29, 2014

Hi

mo am worried about my job can I work or not if my chest X-ray-Ray negative .