Positive TB skin test?

ragingmomster, BSN, MSN, RN · Aug 25, 2005

Were you born or raised outside the US? There are other countries where immunization is common, and that would cause a + PPD. I am surprised the doc is putting you through another PPD. Why take a chance on causing anaphylaxis if your body is already responding in an allergic fashion to the first test.

In the future you should refuse the PPD and just hop to the CXR.

This is assuming that there is no way possible that you were exposed to anyone who has any kind of TB.

Anyone else?

MIA-RN1, RN · Aug 25, 2005

I had my annual TB skin test two days ago. There is an approx. 6 cm red bump on my arm where the PPD was injected. My doctor looked at it today and ordered a retest for my other arm. He said if I have a reaction to the second test, then he will do a chest X-ray. Has anyone else had a postive TB skin test? Does it affect your employment, or ability to be hired? I am still a student and will be starting job interviews this semester.

Yes I had a positive PPD in 1992. I've never been out of the country. My doctor had me get Xrays (negative) and testing at a pulmonologist (I don't remember what testing was done)> Then I had to take INH for 12 months along with a vitamin supplement---maybe B12 or B6.

I NEVER get PPD's anymore but everyone and his brother wants a chest XRay it seems. Now I have a copy of my most recent chest film report and show it to employers, school etc. I also got a letter from the doc stating when I converted, what I took and for how long and that I never had a positive XRay.

We never figured out how or where I was exposed, it was just after my first expedition into nursing school and the theory is that I breathed it in there since my PPD before that was in 1989 or 90 and it was negative. I was never sick, just exposed. Since you don't have symptoms, that is likely your case too. Don't worry about work, my doc also told me that its not uncommon for healthcare workers to convert their PPD's. He did recommend I get my kids and hubby checked, and I did and they were all negative.

MIA-RN1, RN · Aug 25, 2005

Were you born or raised outside the US? There are other countries where immunization is common, and that would cause a + PPD. I am surprised the doc is putting you through another PPD. Why take a chance on causing anaphylaxis if your body is already responding in an allergic fashion to the first test.
In the future you should refuse the PPD and just hop to the CXR.
This is assuming that there is no way possible that you were exposed to anyone who has any kind of TB.
Anyone else?

Is an anaphylactic reaction possible when you repeat a positive PPD? I was told that they could repeat mine, it was positive in 1992, and the worst I'd get was a bigger mark on my arm. They said a positive PPD isn't an allergic reaction but instead it is the reaction of your bodies antibodies to the tuberculin. I've often thought of doing it just to see if I react again or if it was the type of PPD I was given--the four-pronged tine test vs the ID they do now.

Room2Move · Aug 25, 2005

Thank you for your replies. Coopergrrl, what is INH? I haven't been out of the US and always tested negative. We have to be retested every year for nursing school. All I can think of is that I was exposed to it during clinicals. I didn't have any patients diagnosed with TB, but I did do a rotation on a respiratory unit. Raging mom, my doc said he'd do a CXR on Friday if the second test is positive.

Nurseinthemaking · Aug 25, 2005

One of my clinical instructors had a positive and she is not sure why either, everything else came out negative.

What I am wondering is, if they inject it incorrectly can it be a false negative or a false positive. I just had a TB test for work and it didn't make a bleb. She went in deeper then she should have and it never "skeeter bited" up. So if the test was not done properly is it a sure way of detecting?

Mine was negative, but I vaguely remember my instructor saying in order for the test to be accurate you need to see the bleb when first administering. Am I remembering wrong?

MIA-RN1, RN · Aug 25, 2005

Thank you for your replies. Coopergrrl, what is INH? I haven't been out of the US and always tested negative. We have to be retested every year for nursing school. All I can think of is that I was exposed to it during clinicals. I didn't have any patients diagnosed with TB, but I did do a rotation on a respiratory unit. Raging mom, my doc said he'd do a CXR on Friday if the second test is positive.

its the short name for isoniazid, the antibiotic used to treat TB.

My guess is that you probably just got exposed somewhere. From what I understand, that's how it can happen. Happened to me.

MIA-RN1, RN · Aug 25, 2005

One of my clinical instructors had a positive and she is not sure why either, everything else came out negative.
What I am wondering is, if they inject it incorrectly can it be a false negative or a false positive. I just had a TB test for work and it didn't make a bleb. She went in deeper then she should have and it never "skeeter bited" up. So if the test was not done properly is it a sure way of detecting?
Mine was negative, but I vaguely remember my instructor saying in order for the test to be accurate you need to see the bleb when first administering. Am I remembering wrong?

Im not a nurse yet either but I remember watching the NP at work do it and she said you need to see a bleb. Not totally sure tho.

Whispera, MSN, RN · Aug 25, 2005

If there's no bleb during the administration of the test, then the results aren't reliable. Even if you have a reaction, bleb or not, it doesn't mean you have TB, it just means you've run across the germ somewhere, sometime, and it's camping in your body. The chest xray is what looks for where the germs are living. Also, you can have a small reaction without it being significant. That's why they're measured. Many nurses have positive reactions, since they care for patients and who knows who has TB that's cared for, necessarily. Patients are given TB test, but not often in isolation until they're positive. Again, a positive test only means the germ is present.

HeartsOpenWide, RN · Aug 25, 2005

I had my annual TB skin test two days ago. There is an approx. 6 cm red bump on my arm where the PPD was injected. My doctor looked at it today and ordered a retest for my other arm. He said if I have a reaction to the second test, then he will do a chest X-ray. Has anyone else had a postive TB skin test? Does it affect your employment, or ability to be hired? I am still a student and will be starting job interviews this semester.

At the office I work at, when we have a positive TB we send the patient for a chest x-ray. A poss TB does not mean for sure that you have it, it can just mean that you were exposed to it. It can affect employment, but once they treat you your good to go.

**RosesrReder, BSN, MSN, RN** · Aug 25, 2005

I had a positive TB. After the x-rays it showed I was fine. The Dr. started my on a 9 month treatment of Isoniazid and B-12 treatment with montly liver exams. 10 mths later here I am, happy I completed the treatment and without a worry about it affecting my career choice.

Best wishes :)