TB skin test...a reaction??

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On Tuesday I went down to employee health services to get a physical for my new job (I am a recent grad) and got the regular work up. I did a drug screen, tb test, blood draw for titers.

I went back on Thursday to get my tb test read. The NP marked it a positive. I have a red blotch on my arm from the test and absolutely no induration. She sat there with her eyes closed, used her other hand and said no induration, but I don't like this. Then proceeded to talk to me about getting in contact with the health dept, omg!

Now this blotch on my arm is bruised in it and I can see the needle insertion site. Is this normal? My previous tb tests never caused any problems. I am getting a bit nervous here. I am scheduled to go back on Tuesday for another test. Any thoughts?

Also my drug test results have yet to come back. I am drug free, what is the hold up there? She asked if I was sure I had not taken any drugs.

I guess it was just not my day...

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Specializes in MICU for 4 years, now PICU for 3 years!.

I always seem to get a localized red, itchy reaction with every TB test I get, but they always come back negative, even if the irritation is still present. The bruise kinda concerns me. It seems to me that when we learned about giving ID shots (aka TB tests) you should not bruise. I think they said if you bruise, the needle went to far and the results are invalid... maybe I am just thinking I remember that, but I really seem to recall that.... hopefully someone else on here has more definite answers for you. Good Luck with all the rest of your tests!

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I have been getting a reaction to my PPD for about 3 years now. It is very similar to what you describe. It is a large red mark at the site where the test was given. There is never any induration and the test is always read as negative. One person told me that it could be an allergic reaction.

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I get that same reaction every year and every year the nurse looks at it and tells me it is a mild allergic reaction. It concerned me at first but now I warn the employee health nurse before she does it. I can have the red mark and bruise for up to a week. Hope this helps

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Ok, well I feel much better now. Thanks for sharing that with me. I will let the NP know about this on Tuesday when I go back for my retest.

Thanks for the help!

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All tb- or ppd skin test means is when you have itchy or skin swells up there's two possibilities you have tb which is air born or you have been exposed to tb or you have tb. I have been exposed because I worked in nursing home for long time as CNA so when they did ppd mine came out positive my site was red swelled up size of quarter. So now I have to take a chest x-ray which I don't like because of radiation. I'm not sure it is so safe?

If you do have tb they usually give meds for awhile and chest x-ray. ? ? ?

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Specializes in NICU, Infection Control.

I did some TB testing in the past--I remember learning that 40% all TB tests either bruise, bleed or both. Mine always did. It was recorded as a 4mm "bruise" on the report slip. When I read a test, I was instructed to flex the hand towards the elbow so the surface of the arm was relaxed. I went by feel, not by sight. Redness didn't count, induration did.

I suggest you go to the health department, tell them your story and ask for another skin test. You could also go to your regular health care practitioner.

Good Luck! Don't worry yet, OK?

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I test positive. I have since I was four. Just means I was exposed. I have to get chest x-rays instead of ppd. No big deal. The funny thing is my twin brother still tests negative. I can't imagine how I got exposed and he didn't.

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Specializes in Psych, Derm,Eye,Ortho,Prison,Surg,Med,.
LindseyLou2222 said:
Ok, well I feel much better now. Thanks for sharing that with me. I will let the NP know about this on Tuesday when I go back for my retest.

Thanks for the help!

A positive reaction only indicates that you have had some exposure to the bacteria. An X-ray is followed up to show that you have no disease.

I have had much exposure to TB, as I worked in TB for many years (before Izoniazid). My reaction is strongly positive, but no disease.

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Specializes in NICU, PICU, educator.

Ask to be retested with the thirmosal free solution. I had the same reactions and when they did this there was no redness.

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A positive TB test is indicated, as you know, by degree of induration. If you had no induration, your bruising and mark are most likely related to:

  • insertion of TB syringe too deep (in which case, I guess you could request another test if you really wanted to)
  • a possible small allergic rxn to the preservative or something in the tuberculin solution used (this happens to me as well)

Does it seem to be getting lighter? My last PPD took 2 weeks to go away completely!

I can't believe she asked you if you're sure if you haven't taken any drugs. Way to make you even more nervous! Sometimes certain meds can affect drug screens, but I'm sure they asked you about that.

Keep us posted on how you are!

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My "blotch" is still very red. It seems to lighten and then darkens again. Bruising is pretty much gone though. I go back on Tuesday for my retest. I will keep y'all posted. Hopefully my drug test results are back as well.

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