Positive ppd test

rn4ever? · Apr 26, 2008

They might require you to have a chest x-ray. A positive PPD skin test doesn't automatically mean one has TB.

mom2michael, MSN, RN, NP · Apr 26, 2008

A positive PPD test means you've been exposed to TB, doesn't mean you have it. A chest X-ray will probably be the next thing and then they'll go from there. A co-worker of mine tests positive every time we do ours, she has her Xray to make sure it hasn't progressed since the last time she had one and all is good. She has tested positive for the last 15 or so years she said and her X-rays always look the same.

agr8rn, ASN, RN · Apr 26, 2008

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Just moved to new area. doing pre-employment stuff for new job...

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My tb test read as positive today-now what happens? I'm stressed, this has never happened before. any thoughts?

If you've converted to a positive ppd, that means that you have been exposed to or come in contact with someone who had active tb. Can happen to anyone these days. (i would also say if you were born in another country, you may have had a bcg vaccine, but you indicate it was never positive in the past)

Also, make sure that the test was truly positive, many nurses who don't work in infection control or who don't deal with them on a regular basis, misread them.

I worked in a prison as an icn, so i know the drill! Did hundreds of tests a month...

Positive ppds are read by the induration, not the redness.

Think of a mosquito bite. It's a nasty area of redness and induration (the bump of the bite)

if your test looked and felt like that, it is positive if it measured more than 10mm.

If they simply saw it was read, it was not positive.

If it was positive, then you must be screened for symptoms such as cough, unexplained wt loss, night sweats, coughing up blood, etc.

You will also need a cxr to r/o tb. Likely if you have none of the above symptoms, you are not active.

You have a few options, tb will not affect you now if you are young and healthy; it'll bury itself in your lungs until you are run-down and then it strikes.

The cdc recommends 9 months of inh therapy; this will not 'cure you' but it will greatly reduce your risk of becoming active in the future.

The greatest risk is elevated liver enzymes. Usually they don't recommend for people over a certain age.

In that case, you are just observed yearly.

Good luck. Feel free to ask me any questions if i haven't answered them here.

Amanda - resident cruise goddess

Whoo hoo!

agr8rn, ASN, RN · Apr 26, 2008

One last thing...

Anyone who tests positive once, should not ever have the test again

once you are positive, you are positive. No need to repeat the test. You could actually have a severe reaction.

Just get the chest xray when required. Don't let anyone tell you that you have to take the ppd again.

Nurse in last post whose friend has been getting it every year for 15 years... Should not be getting it... Some will try to force you, but don't take it.

They should screen you for symptoms and ask for negative chest xray within last year.

Again, it's that knowledge deficit...

Hope that helps.

Amanda D. :nurse:

aeauooo · Apr 26, 2008

Best source of information of TB diagnosis, treatment, and prevention:

http://www.cdc.gov

Epona · Apr 27, 2008

Hi foster's mom. Make sure too that you wait the full 72 hours I believe it is. I knew of someone who went back in two days and they thought it was positive. The nurse asked her to come back around the 72 hour mark and they ruled it negative. Good luck!

foster's mom · Apr 27, 2008

Thanks so much to all for the info. Helped alot.

lanefrost · Jul 10, 2008

Ok here is the deal, I am a health specialist, just came into the sector. Previous job was in administration in the corporate world. I took a TB test, and so did my wife who works for the same hospital. Her test site in less then three hours only showed a small needle mark where the skin test was applied. Mine went up into a blister site about around as a quarter. In 48 hours the area was red and not as swollen as prior. It had some swelling in the area and still the size of a quarter. The area did not exhibit a huge raised bump. The bump actually was not really raised, but laid under the skin. It was red as stated the size of a quarter, with the swelling under the skin with a slight swelling above the size smaller then the redness, which was quarter size. The LPN checked it, felt the swelling and gave me a negative. In 72 hours the site looked better then 48 hours. Less swelling, less redness. I have looked and been told that is it is positive there will be swelling the size of a dime, how high is the swelling to be, and what else should there be. I am afraid this LPN may of read it wrong. I have not been around anyone with TB. I have never been tested prior. As stated my wifes test was negative, her area looked like nothing. I heard the area should of had what looked like a wheel around it, what should I do if I believe this LPN did not know how to read the test??? I have no problems breathing, no symptoms, so what is negative what is positive??? I am confused. I heard the size of a dime with even the slightest raised area is positive. How much swelling should there be???

agr8rn, ASN, RN · Jul 10, 2008

Sounds to me like your test may have been positive; either that or you had an allergic reaction to the ppd solution (it does happen.)

Any amount of induration that can be palpated greater than 10mm (5mm if immunocompromised) is considered positive. Imagine a mosquito bite - a positive reading looks like that generally. (ie it is red and has palpable swelling/firmness above or under the skin)

Anyone can be exposed in the community without even knowing it; it's much more common now than 20 years ago.

If you think you were misread, mention it to your family physician and get a chest xray.

A positive test doesn't mean you have TB, just were exposed to someone with it.

lanefrost · Jul 10, 2008

Thank you, will go to my physician.

PsychRNOhio · Jul 10, 2008

I am one of tose oddities who have an allergy to the serum

Just need a chest x-ray yearly instead