I Need Help Possitive Looking PPD

nurse4theplanet, RN · Oct 10, 2005

It is easy to come into contact with TB and not know it. I recently had a scare when I had a PPD done for a hospital I was volunteering for. My arm was really itching like crazy at the site and I had a huge whelp there...I thought, great! Now I have to take that dang medicine for 9mos or a year or whatever, but after I quit scratching it went away. Leave it be. If it is read as positive, then they will just give you a chest x-ray. My husband tested positive for TB along time ago and they did a CXR and it came up clear. He never had to take the meds and now he can no longer get the TB skin test done.

Home Health Columnist / Guide · Oct 10, 2005

"pink size of quarter" sounds more like allergic reaction to preservative. you are looking for raised inderation usually white or red, that is what you measure.

possitive result is raised area over 5mm

see:

allrefer health - tuberculin skin test (pictures, images, photos ...

tuberculin skin tests

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obtech2nurse · Oct 10, 2005

Same thing hapened to me. I had it read at 72 hrs and it was red and clearly defined but not really raised to much. The nurse that read it said nothing about it. Two days later it was iching and I started to scatch at it. My house supervisor saw it (it was bright red!!!) and ased what happened. I told her it was my ppd. She sent me home!! I had to go back to the healthcare nurse get it reokayed and a note to go back to work. By then it had went away and the nuse tought I was crazy!!! Well top it all off I am in nursing school and I almost got suspended from class also! That was what I was afraid of the most. Turns out it was just an allergic reaction. Can you say you are allergic to it and just a chest xray each year?

mysticalwaters1 · Oct 10, 2005

Same thing hapened to me. I had it read at 72 hrs and it was red and clearly defined but not really raised to much. The nurse that read it said nothing about it. Two days later it was iching and I started to scatch at it. My house supervisor saw it (it was bright red!!!) and ased what happened. I told her it was my ppd. She sent me home!! I had to go back to the healthcare nurse get it reokayed and a note to go back to work. By then it had went away and the nuse tought I was crazy!!! Well top it all off I am in nursing school and I almost got suspended from class also! That was what I was afraid of the most. Turns out it was just an allergic reaction. Can you say you are allergic to it and just a chest xray each year?

Happened to me after I had no problems with them before. Infact you can still see a little pink scar from the darn thing after 3-4 years! The induration was less than 5mm so it was negative. It must be perservative reaction b/c everyone I've gotten so far 2-3 since have not been like that at all. I thought maybe how it was administered caused it too but probably not. I felt the nurse injected it to much to the surface of my skin because the bleb was humungous than any I had seen and I have sensative skin. I was a student at the time. I don't know if that can be a factor at all. I was just going by the average bleb I see and for some reason this was twice the size. Could just be technique but I really don't know if that can do that?

WSU_Ally_RN, BSN, RN · Oct 10, 2005

that happens to me every time I get a PPD done here at school! Just try putting some hydrocortisone on it, and try not to scratch. I have never had a + reaction, just localized allergice reaction, which is much different than a + PPD. Good luck!

Tweety, BSN, RN · Oct 10, 2005

Could be an allergic reaction, but the disturbing part is you say it's swollen. I doubt they are going to take the chance on a swollen area and not realize that it has the potential for a positive result.

Good luck.

SmilingBluEyes · Oct 10, 2005

When this sort of thing happens where I work---if there is any question at all, a CXR is done from then on, no more PPD.

**RosesrReder, BSN, MSN, RN** · Oct 10, 2005

I tested positive, had a chest x-ray and labs done. Followed a 9 month Isonazid treatment and I am fine. :)

Good luck to you

MadisonsMomRN, BSN, RN · Oct 10, 2005

I am starting a new job Monday. Three days ago I had my PPD test done. I noticed that the area is pink the same day, the size of a quarter, and is swollen, not painful, bit itchy. Three days have passed and it have not improved. I have to have it read Monday, and it's not really looking good. I have not been working for 6 months, and it's pretty unlikely I'd have come into contact with TB. I have had so many tests done in my life and I don't recall this kind of reaction in the past. The only differences between this test and those of the past are that the nurse giving the shot held my skin by the back of my arm to make the skin tight (perhaps making a deeper placement of the needle) and I believe I have never used the brand because in the past the PPD seems to make my arm tingle and feel odd and this did not. I wish I could find more photos of possitive TB tests just to ease my mind. Any thoughts?

You should have a PPD read 48-72 hours or its no good. At least thats the way it is here.:)

TiffyRN, BSN, PhD · Oct 10, 2005

I used to have a positive PPD due to BCG inoculation as a child so I didn't get the PPD for many years. Then they determined I shouldln't be reactive anymore, so I had the PPD last year and was negative. I just had my annual PPD done about a month ago and my story sound identical to the OP's. Starting itching and swelling a few hours after the test. The spot was raised and indurated for about 15mm, and very pink and itchy when I went back for the recheck. The employee health nurse examined it, ran a pen over it determining there was no clear margin of the induration (I guess that's important) and declared I didn't have a positive PPD but probably had a reaction to the nickel (preservative) in the PPD solution. She asked did I react to cheap earrings (I do) and then cleared me to go back to work. I just figured I was positive again due to my childhood BCG inoculation but didn't understand no reaction last year. Maybe the PPD solution last year was a different kind/brand and didn't have nickel?

My dilemma is I want to refuse further PPD's as the spot is still itchy, red and flaky a month later. I want to declare an allergy to nickel and refuse further PPD's in the future. They can xray me, or give me the check-off question list like they did for years when they thought I was positive.

I work in a very low risk environment (neonatal ICU) and feel I am at no greater risk to contract TB than if I had a non-healthcare related job. Yes I know some random visitor or parent MIGHT have it but generally the moms at least have had some pre-natal care and we screen for fevers/coughs before allowing visitors back.

Haunted · Oct 10, 2005

WAIT!!! I am confused. If you test positive and have a CRX you no longer have to take the PPD??? Topical (excuse the pun) subject since my registry from a HOT PLACE just sent me back to the stinky occupational medicine clinic today to retake a PPD.

I had it done last week on one of my many days off and it was negative. So imagine my surprise when I got a call from the stinky clinic telling me I needed to repeat the test!

WELL!!! After I was approved for a second on my mortgage, I was able to sprinkle some gas in my car and head off to the stinky clinic to sit amongst longshoremen, concrete pumpers and off shore oilriggers who have not been intimate with a bar of soap since the REAGAN administration to finally be called into the exam room for another heaping dose of attenuated TB into my tender loving arm.

All these things we go through, some days I really ponder whether I would just do better as a Super Model or spokesperson for DAMM