positive PPD

cardiacRN2006, ADN, RN · May 13, 2005

hello I am new here and have only posted my basic introductory post. Here is my question I guess. During my pre nursing physical I tested positive on my PPD. The first one was 5mm the second was 40mm. I had the chest xray which was normal.I am now on 300 mg isoniazid for 9 mos. I have tried to get information about this on the web but its all so cinfusing. I am to start the lpn program in Aug.I did contact my instructor who then contacted the health dept and determined I CAN still attend class. I guess what I want to know is do I actually HAVE tb? all responses would be greatly appreciated,I love this site!

If the CXR was negative, then you do not have active TB. The positive PPD means that you have been exposed to TB somewhere. 9 months of isoniazid? Isn't the usual course 6 months?

CrissyLynn · May 13, 2005

I believe it is but my dr. said on a 6 month regiment I have a 65% chance of not developing active tb and on 9 month its 75%. Its so confusing because I have no idea where I could have been exposed.I have had tb tests in the past,(my father was in the military and we traveled overseas) and I never had a reaction at all.It makes me wonder thats for sure. thanks for your reply

NP-to-be · May 13, 2005

I believe it is but my dr. said on a 6 month regiment I have a 65% chance of not developing active tb and on 9 month its 75%. Its so confusing because I have no idea where I could have been exposed.I have had tb tests in the past,(my father was in the military and we traveled overseas) and I never had a reaction at all.It makes me wonder thats for sure. thanks for your reply

Hi CrissyLynn -

I also have positie ppd's. I was started on a 9-month INH regimen (which is no the starndard according to the CDC and it is actally 90% effective). However, I had adverse side-effects (elevated liver function tests) and the treatment was discountinued. The doctor recommended a 3-month course of rifampin but I refused. I've decided to take my chances. As long as you have clear chest x-rays, you are clear for classes and any type of practice. I was amazed at the number of people who have positive ppd reactions and work in healthcare settings - it is nothing to worry about. Since it is deemed a public health issue your doctors are obligated to urge you to seek treatment ... but I know many people (myself included) who have refused due to the side effects. Be careful ... INH is some powerful stuff !!

Good luck and try not to worry about it !!

-Jen

CrissyLynn · May 13, 2005

Thanks for your post. I really am clueless here,my doctor hasnt talked to me about this at all except what she HAS to say. I came home crying hysterically because I thought I was going to die.Its crazy! I dont know anything about the meds,and she hasnt scheduled me for any follow up visits. I dont know what side effects to even look for. Maybe I need another doctor,the thing is I really like her personality.I dont know,maybe I am over reacting too. LOL The important thing is that I am NOT going to die and I can still go to school!

NP-to-be · May 13, 2005

Thanks for your post. I really am clueless here,my doctor hasnt talked to me about this at all except what she HAS to say. I came home crying hysterically because I thought I was going to die.Its crazy! I dont know anything about the meds,and she hasnt scheduled me for any follow up visits. I dont know what side effects to even look for. Maybe I need another doctor,the thing is I really like her personality.I dont know,maybe I am over reacting too. LOL The important thing is that I am NOT going to die and I can still go to school!

You are NOT going to die !! Just remeber that. But I do understand that it's a scary ordeal ... I was completely clueless when my ppd came back positive. But the reality of the situation is that plenty of people (very healthy people) have positive ppd's. 9-months of INH is the standard treatment for latent TB. Anyone who has adverse reactions from the INH is usually treated with Rifamin for 3-4 months. The 'side-effects' to be aware of are liver related - jaundice of course, excessive tiredness, naueseau ... a few others that I'm forgetting right now. I had an adverse reaction w/ in 10 days which scared me enough to refuse further treatment. The way I understand it is that I have a 10% chance of getting active TB in my lifetime ... I'm willing to take those odds at this point.

Good luck and try not to worry too much. Things will work out fine !!

-Jen

soontobe_RN · May 13, 2005

As far as treatment is concerned or even the testing, I really do not know anymore than the general public. However, I do know how TB is transmitted. I work at a Drug and alcohol Inpatient rehab for adults. When I was pregnant with my youngest son I was very worried about catching anything from my clients, due to the fact that addicts and alcoholics are the most prevalent in these type of diseases.

I know that, first of all, TB is an air born disease. Meaning, you could walk past someone who has TB and is coughing and the next thing you know you are testing positive on the PPD.

What my prenatal DR. said to me was that I was just as much at risk to being exposed to TB at the mall or the movie theater as I was at work.

I was told by one of my intructors that most people who work at a hospital for an extended period of time end up being exposed to TB. Like the other post said, it doesn't mean you have TB, it just means you have been exposed. I really wouldn't worry to much about it. As long as you take care of yourself you will be fine. Plus, you can still practice, as long as you get your Chest x-rays when the DR. tells you to.

Best of Wishes,

Jennifer

oregonrene · Aug 5, 2005

.

Nurseismade RN · Aug 5, 2005

I believe it is but my dr. said on a 6 month regiment I have a 65% chance of not developing active tb and on 9 month its 75%. Its so confusing because I have no idea where I could have been exposed.I have had tb tests in the past,(my father was in the military and we traveled overseas) and I never had a reaction at all.It makes me wonder thats for sure. thanks for your reply

Hi,

I always test positive for TB, this is due to the fact that in London, school kids were given TB Vaccinations. I wonder if this happened to you, since you said you travelled overseas. Ask your Mom. If you did have a TB vaccination, The technical name is "BCG Vaccination" you will always test positive and a normal chest xray is only what is needed. :) Most hospital's employee health are aware of this.

**RosesrReder, BSN, MSN, RN** · Aug 5, 2005

If the CXR was negative, then you do not have active TB. The positive PPD means that you have been exposed to TB somewhere. 9 months of isoniazid? Isn't the usual course 6 months?

I had a negative CXR I went through a 9 month isoniazid treatment. The Dr. recommended it along with regular liver check ups.