Positive TB Skin Test

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I am a new grad nurse just off orientation. I had my annual TB test Tuesday and when I went back to have it read today was told it was positive. This is my third skin test since starting nursing school. Each time the area has become itchy and red and swollen, but the area of induration isn't what I would call hard. It looks the same way this time. There is a red, swollen (soft & puffy, not hard) area where the tuberculin was administered. I told the nurse that this is what my past two tests have looked like and that each time they were deemed negative. She performed another test, which I will have results from on Monday, but essentially prepared me for a visit to the health department and 9 months of TB abx.

Anyone had a similar experience? If I truly have been exposed I will certainly take necessary measures, but I also do not want to take 9 months of hepatotoxic medications if this is simply a case of sensitive skin. Thanks in advance. :)

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Specializes in Med/Surg, Ortho, ASC.

Why not go for the gold standard - a simple chest x-ray. You don't traditionally go straight from positive PPD to 9 months of meds. Ask your PCP for the film - that should help speed the process along.

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Good advice - that seemed abrupt to me, too.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

There are also blood tests available: the quantiferon gold and the TB spot. They can clarify your TB status if your skin test is inconclusive.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I think you need to follow up with your PCP and follow their reccomndations. We cannot offer medical advice here. These links may help

http://www.cdc.gov/TB/

http://www.cdcnpin.org/scripts/tb/cdc.asp

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Thanks for the links. Wasn't looking for medical advice, just seeing if anyone had been in the same position and could lend support.

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Specializes in Med/Surg, Ortho, ASC.

I've had 2 patients in the last 2 weeks who've had positive PPD's yet clean-as-a-whistle chest films. Both had been started on prophylactic meds X 9 months. When I asked one of them why with a negative xray she had to take the meds, she said she had no idea. She was just doing what the doctor ordered :eek:

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Specializes in Critical Care, Trauma, Transplant.

To the OP, I to just got my TB test done, and I also had a red, swollen looking circle. This is a pretty typical reaction for me, and I have been told that I have an allergic reaction to the preservative in the injection. Maybe this is the same with you? I dont have allergies to anything else really, but I always react in the same way to my TB tests...

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Specializes in LTF, ALF, Primary & Rhuematology offices.

Not medical advice my experience is what I'm sharing. I had something similar this year. I have never been positive on a ppd but I've had a lot over the years bc some facilities here won't use another facility ppd and I don't want to go to the hospital or wait for xray for hrs to come. Anyway I have developed an allergy/ to the ppd. I noticed this last time I had one. I had redness, crazy itching, and was swollen about the ez of a big lemon it looked like a spider bite very soft though. I Had to take benadryl but just do what the other poster said and do the cxr saves a lot of headaches. Ended up with a cxr and a new allergy listing from my md

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Specializes in Hospice / Psych / RNAC.

You are not required to take the meds; it's strictly a personal decision. You can't infect anyone with latent TB. It's estimated that over 1/3 of the world's population has been exposed to TB. I believe it's something like 1 in 10 latents will turn active. Also you must consider the drug resident TB strains and also is it actually TB or another myobacterium. I have had latent TB for > 20 years. I know several nurses who have latent TB as well and only 1 opted to do the treatment (I live in an area with a large third world population). We do a yearly chest and that's about it. A 10% stat isn't enough for me to take the 9 month med regime. Also, the longer you are latent the chances of it going active lessen.

The thing with me is that I don't actually believe I have latent TB due to when the "nurse" (using the word with much hesitation) read the result, it wasn't hard and it was under 10mm. It was reddened with a rash type appearance. Whatever ... later on maybe 16 years later I was hospitalized and they automatically did a TB test on me though I told them I had latent TB (more of the same "nurses"). Low and behold it was negative both times with absolutely nothing but a round ink mark. So ... I still do the chest and don't worry too much about it.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thanks for the links. Wasn't looking for medical advice, just seeing if anyone had been in the same position and could lend support.

It's not that I wasn't supporting you but without seeing you PPD or the repeat I can't tell you whether you should or shouldn't go through treatment. Did you have a one or two step. In the past if it turned red ......why do you keep getting tested instead of a CXR? What does your doctor recommend? Was it redness or induration she measured?

Whatever it is I'm sorry you are going through this....:redpinkhe

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Specializes in Nephrology, Cardiology, ER, ICU.

I think we have two many opinions to give you the advice you want.

I would talk with your doc and if needed, seek a second opinion.

The links provided earlier should help too.

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