Positive TB test?

Nurses General Nursing

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I had a reaction to a TB test a couple years ago when I first started nursing school. It was a 7 mm raised area. I immediately got a chest Xray, which was negative. The doctor ruled that since I had never been out of the country, never really been in a hospital or around sick people, and was a healthy 20 year old, that the test was negative. He said maybe it was because I had 'sensitive skin'. (Go figure...)

Last year, I had another test, which was negative, with no reaction.

I had another test today for my new job. I am so darn worried this one will be raised again and I'll have to go through the trouble to get another chest Xray and all that jazz. Its been about 12 hours and the area is very red and slightly swollen.

My question is this....why do I get these reactions even though I obviously do NOT have a latent TB infection?

Have any of you had a positive test, and if you have, is it an ongoing thing?...like every year you go through the same jazz to get a chest Xray?

Specializes in Cardiac, Acute/Subacute Rehab.

Hi!

I, too, have a +TB reading that could probably be interpreted either way - as an induration OR simply a reaction to the PPD solution. It doesn't show up in the first step, but always shows up in the 2nd step for me.

It's not a big deal, really. The last person to read a skin test for me recommended that I don't have any more skin tests b/c she thought it was an allergic-type reaction, rather than induration (which it had been called, previously). I just go to straight to CXR.

Just be upfront about it - you'd be surprised at the lack of concern from potential employers (as long as your cxr is clear, of course ;)).

Is it possible that you are a carrier of TB? I remember my CNA teacher discussing this with one of the other students but I wasn't really paying much attention...something about how a person can be a carrier of TB without ever having any signs of having the infection. If you had sensitive skin you would know it because you would have problems with laundry detergent, soap, lotions and things like that, my daughter has the same issues. I tried looking online but couldn't really find any specific information on how one can be diagnosed as a carrier (will you be asymptomatic but have a positive TB test?) and whether or not anything can be done about it. I did find that a person can be a carrier of TB all their lives and it can always remain inactive or it can become active if your immune system is affected due to stress etc and you are only contagious if it becomes active during which time I assume you would become symptomatic. Curious to hear what others think about this....

A carrier would be someone who has been exposed and has a latent infection. That is what a Chest Xray rules out. If you are a "carrier", it would show up in the Xray and you would be required to take a long course of antibiotics.

Specializes in Med/Surg, Ortho, ASC.

If you have a positive reaction to the tuberculin serum and a negative chest x-ray, you should not be subjected to standard TB tests in the future. It is assumed that you will test positive.

A negative CXR subsequent to the +TB test should be sufficient in the future.

Specializes in Geriatric nursing.

I had a positive TB skin test too and I remember that a nurse practitioner told me that there is no need to get the skin test done again once you get a positive result..because it will always be positive.

I was also told that I had latent TB (maybe due to exposure to someone with active TB). So, the bacteria is there but, it's inactive..you need an antibiotic (don't remember the name) to get rid of it.

Another possible reason I had a positive result was that I had a BCG vaccine as an infant.

I was not asked to get the X-ray done again since the physical examination revealed no signs of active TB.

Hope it helps.

I have a nasty allergic reaction to the tb test. Like my whole arm from my wrist to my elbow turns almost purple and very painful. I just get the chest x-ray now. Actually my latest employer doesnt even do the tb test for employement, we have to get a blood test. Which came out negative.

Specializes in PICU, Sedation/Radiology, PACU.

7mm isn't considered a positive reaction unless you have HIV.

A positive TB is 10-15mm (depending on your facility's policy) of induration (raised, hard area). Redness and general puffiness have nothing to do with the reading. So you really didn't need a chest x-ray and you have actually never had a positive reaction.

If you really had a positive reaction, you wil always have a positive reaction because it indicated true exposure to TB. Some people are sensitive to the agent in the TB test and it causes an inflammatory reaction that looks like a positive, but it isn't indurated. You're probably sensitive or even allergic to the ingredients in the TB test.

Btw, a chest x-ray looks for an active infection, not a latent one. So you can still have latent TB and a clear chest x-ray.

The last post was good stuff.... it has to be >10mm raised area to be considered positive. Some people overreact to those tests or just simply dont read them correctly.

I got a TB test today. The bump was gone by the time I got home, lol.

"Btw, a chest x-ray looks for an active infection, not a latent one. So you can still have latent TB and a clear chest x-ray. "

I was about to post the same thing but you beat me to it! :D

Specializes in ER.

I had a + test 25 years ago, (no clue where I was ever exposed) but I had to take INH and Rifampin for one year, even tho the CXR was clear at the time.

Every new employer does the same thing- you tell them you had a + reaction, and they do either a CXR or CXR and a blood test. As long as those are both clear, no concerns. It's pretty common actually.

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