can anyone throw light on this pls?.

[nina_RN]

pt doesn't remember whether she got BCG vaccine as a kid. pt tests +ve for a TB skin test, MD orders an xray that shows negative to abnormalities.pt put on 9 mnths INH tx for latent tb.

pt advised not to get another skin test since it is always going to show +ve. 6 years later, pt undergoes quantiferon gold tb test( a blood test) and result comes out postive. what does this mean? Something to be alarmed about?

[Erclifton85]

Latent TB is much different than active TB; Latent must be treated so it does not become active. Isoniazid or Rifampin are the treatment she was on. After treatment she should be fine and without TB although antibodies against TB still exist. I'm guessing the bloodwork shows that patient has antibodies against TB?? I can't say for sure. Wish I could be more help.

[nina_RN]

antibodies and the positive blood test. that makes sense.

i was thinking since she's taken the INH treatment, the latent TB germs should've been killed by now resulting in a negative blood test.since the pt isn't symptomatic, I'm assuming the INH didn't do its job or wasn't taken correctly and couldn't eliminate all the germs.

a positive blood test means either the latent tb still exists or there are germs that have taken an active form.

a chest xray was ordered to rule out either again.

[Erclifton85]

I see. As long as the CXR is negative the TB will be considered latent... my patient got a mantoux that was positive, Dx with latent TB, 6 mos Rifampin, and now given the OK to start Imbrel. (I work home health, I don't have any experience with the blood test). I see what you're saying, it could be that INH wasn't effective or non-compliance. Let me know whats up, I'm interested.