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Discussion

Positive PPD

15 mm induration, had a CXR, negative findings. So I have to go to Dept. of Health and take another blood TB test and then, if positive, start 9 MONTHS of antibiotic therapy. Had a neg PPD 6 mos. ago! Very stressful. Health dept says these TB bacteria basically lie latent, waiting to strike without warning if you get run-down for any reason and can turn into active TB. :confused: Anyone else have this happen to them? MD assures me it happens to nurses, and I was prob. exposed at work or maybe in the community!

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It's pretty common, that's why nurses and other medical staff are tested yearly.

Hi fancy faye!

same thing happening to me, had a positive ppd 14mm, had cxr yesterday still waiting for the result then will see my doctor by next year..

i like your name, i remember the character named fancy faye at dark shadows

ooopps i mean will see my doctor next week, i read that if you are PPD positive even if your cxr is normal you will still undergo the 6-9 months treatment

I had to have a PPD test because I was volunteering at the local hospital, and I was shocked when it came back positive (VERY positive, like yours). Had a negative CXR but decided to go ahead with the prophylactic treatment. I was told it was not mandatory and that I could still volunteer at the hospital even if I didn't take the meds. I don't know if that is the case with nursing school as I haven't started yet. I thought I would rather be safe than sorry, and I was given a choice of meds. I elected to go the INH route (didn't like the idea of orange body fluids from rifampicin, especially with my new contacts). I have not had any adverse effects from the med so am pleased that I went ahead with it. Five months down, four to go! The thing is, I'm pretty sure I would have had to be vaccinated against TB as part of the immigration process (came to the US from England 11 years ago), which would explain the positive result, but I couldn't find documentation to prove that, so I have to assume I may have been exposed at some point or another.

It's not the end of the world, so try not to let it stress you out.

Don't worry about it too much. I agree with what everyone else has said so far. Do you have sensitive skin? Sometimes you can have a local reaction that looks very much like a positive reaction. A few years ago, I had a positive reaction but it turns out it was just that particular PPD serum that caused me to react. I've been negative ever since. That being said, if you are truely positive, it's not that uncommon umong health care workers and you will be fine.

15 mm induration, had a CXR, negative findings. So I have to go to Dept. of Health and take another blood TB test and then, if positive, start 9 MONTHS of antibiotic therapy. Had a neg PPD 6 mos. ago! Very stressful. Health dept says these TB bacteria basically lie latent, waiting to strike without warning if you get run-down for any reason and can turn into active TB. :confused: Anyone else have this happen to them? MD assures me it happens to nurses, and I was prob. exposed at work or maybe in the community!

hmmm never heard of a blood test for TB. Anyway, sorry to hear - that sucks. However, new infection is likely to get activated in the first years, so it's probably a wise thing to take the INH. Don't forget the B6.

ooopps i mean will see my doctor next week, i read that if you are PPD positive even if your cxr is normal you will still undergo the 6-9 months treatment

You are right - that's some of the new recommendations - "to screen is to treat"

I am what they call a reactor to the PPD test - have to get CXR but have never had to take prophalactic meds. Many people react to the skin test but with them the tb germ is dormant and most likely will never become activated. I no longer take the skin test but fill out a form stating I have no night sweats or recent weight loss.

I had to have a PPD test because I was volunteering at the local hospital, and I was shocked when it came back positive (VERY positive, like yours). Had a negative CXR but decided to go ahead with the prophylactic treatment. I was told it was not mandatory and that I could still volunteer at the hospital even if I didn’t take the meds. I don’t know if that is the case with nursing school as I haven’t started yet. I thought I would rather be safe than sorry, and I was given a choice of meds. I elected to go the INH route (didn’t like the idea of orange body fluids from rifampicin, especially with my new contacts). I have not had any adverse effects from the med so am pleased that I went ahead with it. Five months down, four to go! The thing is, I’m pretty sure I would have had to be vaccinated against TB as part of the immigration process (came to the US from England 11 years ago), which would explain the positive result, but I couldn’t find documentation to prove that, so I have to assume I may have been exposed at some point or another.

It’s not the end of the world, so try not to let it stress you out.

I don't think the BCG vaccine is required for US immigration. Is it commonly given to citizens in the UK?

Also, anyone know if BCG is still given much in Canada?

I don't think the BCG vaccine is required for US immigration. Is it commonly given to citizens in the UK?

Also, anyone know if BCG is still given much in Canada?

I honestly don't remember if I was vaccinated against TB as a child. I know BCG used to be given to kids (my mum had it). I don't have a scar though, so either I had a newer form or none at all. They may have stopped vaccinating routinely years ago as TB has (or rather HAD) pretty much died out. As far as immigration is concerned, we had so many health checks and shots before coming here, I lost track of what we actually received, so I don't know either way. If it is not "standard" for immigrants from the UK, then we probably didn't get it.

I'll leave someone else to answer about Canada. :confused:

I honestly don't remember if I was vaccinated against TB as a child.

If you had a BCG immunization you would have a small, very noticable scar. When I was working in Ethiopia we gave BCG over the right deltoid (this helped differentiate the BCG scar from the small pox vaccination scar, which was given over the left deltoid), but I don't think that practice is universal. I think in some countries it is given on the buttock.

BCG is not given to adults, and usually only given to infants. It is currently used only in developing countries with a high prevalence of TB.

As far as I know, BCG has never been routinely used in the U.S., and never been required for emigration to the U.S.

The PPD reactivity to BCG usually wanes, so that PPD positive adults who had recieved BCG as children are treated according to the protocols for adults who have never received BCG.

http://www.cdc.gov/tb/pubs/tbfactsheets/bcg.htm

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