PPD Allergy?


Specializes in Acute Rehab, Neuro/Trauma, Dialysis.

Sine I have been 17 I have had PPDs done, at first I never had any reactions to it, but every year that I have had it I have gotten more and more of a reaction. Two years ago I had one done and I developed redness, itching, swelling and an itchy throat. I took benadryl and the itchy throat went away. I told the PA when I went to have it read, but by then the swelling had gone down and there was just a little redness remaining. Apparently she never wrote any of it down.

Fast forward to a year ago I was a new hire and when I was told I would need a PPD for the job I told them of my concerns with the last one and they had no problem sending me to the lab to have the IGRA drawn instead.

Now I have begun a new job and at the employee health visit they told me that unless I can show documentation of my allergy I will be required to have a PPD. I called my doctor and that is when I found out there was no documentation of the allergic reaction. It just doesn't seem right to me that an employer would make an employee take something that they feel will cause them some sort of harm. If I were admitting one of my patients and they told me that they had an allergy to something it would be documented in their charts regardless of weather they had any paper work with them.

I am not sure what I can do. I really don't feel comfortable taking the PPD again, but apparently I have nothing to prove my allergy. Any advice on how to handle this?

roser13, ASN, RN

Specializes in Med/Surg, Ortho, ASC. Has 17 years experience. 6,504 Posts

Just ask for a chest X-Ray. If you've shown an allergic reaction in the past, no one should be asking you for a PPD anyway.

dishes, BSN, RN

3,950 Posts

I would discuss the increased sensitization with my doctor and ask them to write a letter recommending that I avoid PPD in order to reduce the chances of anaphylactic reaction, I would make a copy of the letter for my personal files and give the letter to the employee health nurse.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience. 7,765 Posts

Have you had a BCG vaccination?


Specializes in Acute Rehab, Neuro/Trauma, Dialysis. 238 Posts

@ roser13: I told them that I would be more than willing to take an IGRA or Gold test but they said without documentation they were not willing. Thank you for help though!

@ dishes: I spoke with the PA at the time and I tried talking to my doctor today but because the reaction was two years ago and was not documented when it happened there is nothing that she can do for me. Thanks for the advice!

@ MunoRN: I have not had the vaccine, my reactions are not positive TB results they are allergic reactions. Thank you though!


Has 25 years experience. 12,646 Posts

I would ask for a T spot or Quantiferon to be drawn, or start taking an antihistamine prior to my PPD until it is read.

Ask your doctor first if this is a doable plan.

NicuGal, MSN, RN

Specializes in NICU, PICU, PACU. Has 30 years experience. 2,743 Posts

Do you use preservative free? This happened to me and once changed it was much better. I still get some itching but it is tolerable.