positive ppd skin test, neg xray, take meds?

suzanne4, RN · Mar 26, 2006

What type of doctor made this recommendation to you? If you had BCG as a child, you are going to test positive forever. Unkless an infectious disease doc makes this recommendation to you, I definitely would not do it.

Why take a chance of liver problems when you do not need to. I would worry more about my liver, you can easily treat TB, but your liver cannot always be repaired, and that could kill you.

I have never heard of a doctor recommending TB treatment when you are completely negative.

elenova · Mar 26, 2006

Hello, Suzanne, I would like to know too about this problem. My brother didnt go to the army coz of this. He tested very positive twice on Mantoux test- over 15mm (couldnt move his arm for a week) and negative x-ray. He was advised by a doctor to take Rimfapicin, I think for 3 months. He didnt take them, but the doctor warned him about the side effects to the liver and he had to have the liver transaminases checked...

The funny thing was that they told him he has TB earlier in his life or he was in a contact with a TB patient... I am not sure if he had BCG as a newborn.

suzanne4, RN · Mar 26, 2006

If he was born overseas, chances are that he had BCG. This would cause an automatic positive conversion for years and years. That is why a chest x-ray is always done for immigration purposes, they do not use the Mantoux at all.

If CXR is completely negative, there is no reason to attempt to mess up your liver. Until an infectious disease recommends it, I would not go that route.

nrswnabee · Mar 27, 2006

What type of doctor made this recommendation to you? If you had BCG as a child, you are going to test positive forever. Unkless an infectious disease doc makes this recommendation to you, I definitely would not do it.
Why take a chance of liver problems when you do not need to. I would worry more about my liver, you can easily treat TB, but your liver cannot always be repaired, and that could kill you.
I have never heard of a doctor recommending TB treatment when you are completely negative.

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this is my third attempt to post. i hope this works.

i don't know. i took this ppd test bec. i wish to do volunteer work. since i tested positive, the facility referred me to the local health center where i was recommended to undergo "treatment". i did tell them i had bcg as a baby like any other filipino and the doctor says that it's to my best interest considering that i'd be doing hospital work soon. i did ask about the side effects to which she advised that there are but temporary and not life-threatening. i remember that she even told me they'd go away once treatment is completed. i also remember the nurse-coordinator for ptb declaring that it's the state's policy (CT) to have such an aggressive approach to the illness, even if "latent" to "control" transmission.

i told the doctor that i'd like to think about it. to my mind, i know not of any filipino nurse who's had it despite testing positive for ppd. i almost bought the idea of the treatment's supposed benefits but then again, i fear taking medications for 9 months (wow, that long??) for such an "inactive" disease. i said i'd call them but now i know, i won't.

thanks suzanne.

suzanne4, RN · Mar 27, 2006

I spoke to one of our infectious disease doctors about this today, and he said that since you were from the Philippines, chances are that you were in contact with someone in the past that had the active disease and not have know it. He recommends the six month course of INH. This will take care of any bacteria that you may have in your system now, but will not prevent you from catching the disease later on in life. You would still need to use all of the protection at work like everyone else does.

Hope that this helps. A couple of years ago, they were not doing this, but because of the increase in TB that is being seen, they are finding it better to treat you if you were positive from the Philippines. He said the positive from the BCG actually doesn't give you a positive more than 15 years out from the injection, so chances are very high that you were in contact with someone. Same thing for Eastern Europe.

GooeyRN, ADN, BSN, CNA, LPN, RN · Mar 27, 2006

I was never out of the USA but had a Positive PPD, and a negative chest x-ray. I was given BCG a few years prior at a nursing home I worked at that later closed. (So I could not get documentation to prove it.) My PCP did not belive that I would have gotten the BCG in the states. My PCP consulted w/ infectious disease and recommended that I take INH for 9 months so I did. This was ~5 years ago.

suzanne4, RN · Mar 27, 2006

My sister was given BCG in the US years ago, but it was for a specific reason, not to prevent TB. So, yes it is given in the US, I was with her that day.

work4choc · Mar 27, 2006

I had a positive ppd a few years back, as did my dh. (neg x-ray) Since neither of us had the BCG vac, it was assumed we had been exposed to Tb and both of us did 9 mos of INH. We had monthly blood work done to check our livers.

What I learned from one of the MDs that did one of my monthly checkups was that 85-90% of the time, your body will completely destroy it, but that remaining 10-15% of the time, your body has simply walled it off, and if you become immunocompromised in the future, you could develop Tb. The INH is supposed to get rid of it if your body has not, or at least, that is what they told me.

And I was also told to NEVER get the skin test again - I will now need to have chest x-rays instead when I finally enter a program again.

nrswnabee · Mar 28, 2006

I spoke to one of our infectious disease doctors about this today, and he said that since you were from the Philippines, chances are that you were in contact with someone in the past that had the active disease and not have know it. He recommends the six month course of INH. This will take care of any bacteria that you may have in your system now, but will not prevent you from catching the disease later on in life. You would still need to use all of the protection at work like everyone else does.
Hope that this helps. A couple of years ago, they were not doing this, but because of the increase in TB that is being seen, they are finding it better to treat you if you were positive from the Philippines. He said the positive from the BCG actually doesn't give you a positive more than 15 years out from the injection, so chances are very high that you were in contact with someone. Same thing for Eastern Europe.

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wow, thanks so much, suzanne. i have the impression that i should, after all, go ahead with the treatment. do you think i can ask to shorten it from 9 to just 6?? another thing i failed to mention--- i just recovered from chicken pox (1 week from the time i was cleared by the clinic) and will this complicate my having to undergo "latent tb" treatment? i was thinking of starting the treatment by summer just so should anything happen (knock-knock!), i'm not in school.... as to the side effects, was it accurate for the doctor to say that they were temporary?

thanks to everyone else who shared their experiences...this forum is really very helpful. =)

midwife2b · Mar 28, 2006

Yes BCG has been given in the US.

My mom once worked at a TB hospital and it was recommended that all family members recieve BCG. So my sibs and I all got it as children (1960's). I've tested negative for the last 10 years with traditional intradermal test. I was also in a research study when I was in my 30's to see how sensitive a PPD would be years after receiving BCG. I tested positive for almost 30 years.

I had a CXR every 2 years instead of a PPD to meet Employee Health Requirements. No one ever suggested I take any anti TB med.

My youngest sister who is almost 40 was negative after 18 years. Not sure why it took me so long to finally test negative.

suzanne4, RN · Mar 28, 2006

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wow, thanks so much, suzanne. i have the impression that i should, after all, go ahead with the treatment. do you think i can ask to shorten it from 9 to just 6?? another thing i failed to mention--- i just recovered from chicken pox (1 week from the time i was cleared by the clinic) and will this complicate my having to undergo "latent tb" treatment? i was thinking of starting the treatment by summer just so should anything happen (knock-knock!), i'm not in school.... as to the side effects, was it accurate for the doctor to say that they were temporary?
thanks to everyone else who shared their experiences...this forum is really very helpful. =)

You poor thing, getting chicked pox now?

Best bet is to speak with your provider...............they know your case the best.