Postive TB skin test

[morningflower26]

I need some opinions on a positive TB skin test. I recently started a new job and got my TB skin test last week. I had it read on fri and it read positive at 9mm. My employer sent me yesterday for a chest x-ray which came back neg. I do not know where to go from here. Some say repeat the test in a week, some say I need not to repeat the test and take the results as a allergic reaction to the test and do nothing and some say I must go through a 9mth cycle of tx. I am very confused on what to do. Some say it may have been an error during admin.(Needle went to deep into the tissue) Where do I go from here??????? HELP!!!!!!

[mpccrn, BSN, RN]

who read the test? i no longer am able to get the typical tb skin test due to an "allergic" reaction to the serum. i get a large welt, raised, red and it itches and lasts for a few weeks. i now only get chest x-rays q 5 years. the other years i merely sign a paper saying i have no s&s of TB......go figure.

[janis9799]

In school and at the hospital orientation I just went through this week they said that it wasn't a positive until 10mm, or 5mm if you are immunocompromised. I tested positive back in 2002 at 12mm so mine counts for sure. I keep getting back negative CXRs when I have needed to get them for school or work. I get different answers on whether to take meds or not. Most of my docs have said I didn't need to have them...I would talk to your health care provider to see what is best for you.

[imafostermom]

Your employer will have a specific policy in place and be able to tell you what to do next. In our area 10mm is positive, not 9mm. For our students/employees, after the chest x-ray is negative you are good to go. Find out the establishment policy so you can know for sure.

[morningflower26]

I am the first at my employer, so they say so they are really not sure on policy......................

[Halinja, BSN, RN]

When I was in nursing school (and the hospitals where I did clinicals) A clear X-ray gave me a year, then after that year, I had one more clear X-ray. After two clear X-ray's in a row, I'm good to go. I don't have to take them every year. I suppose my employer may want one every five years or so, but no one has actually said so. (I traveled to Africa as a child and was given the BCG vaccine....ever since then I test positive)

The treatment is highly hepatatoxic. I would consider the likelihood of exposure (do you live where there is a high incidence of TB?), and the likelihood of sensitivity (several things can cause false positives, including sensitivity) before I made any decision on treatment. If you are over 35, treatment is not advised, due to the hepatatoxicity, according to the CDC. So at 32, I'd want to be very sure I was actually infected.

I agree with previous posters, 9mm isn't considered positive unless you are immunocompromised. As a matter of fact the CDC now has a breakdown of what is considered positive, and if you are a low risk person, with little chance of exposure, 15mm is considered positive. It's a three tier thing now. 15mm/10mm/5mm.

[Murse901, MSN, RN]

Negative CXR means you're in the clear. There is no need to retake the skin test in a week or two. The negative CXR overrides anything else. If you had sx/sx of TB, then you would possibly need further investigation. Otherwise, don't worry.

It's possible that you're allergic to the PPD, and it's also possible that your lot of PPD is bad. About a year and a half ago, I was working at a nursing home and we had a large group of new hires come in (about 12-15). Several nurses administered PPD to the group and they ALL came back positive to varying degrees. Ruling out administration technique, it had to be something with the PPD itself.