TB Skin Test

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I am a student in the LPN program. Before school starts in September, I have to get a drug screen, background check, take a CPR class, and have a physical performed. All of which I have done. The last part of my physical was to go back to get them to check my TB skin test. It had got a bit red but I wasn't concerned really because I have sensitive skin along with my mother who is an RN. The only RN in the office ok'd it and wrote negative but when I was walking out, one of the med assistants looked at it and said that it looked positive. So everyone started looking at me like a goldfish and they measured it etc. Said it was positive so I did a chest X-ray and obviously I don't have active TB, apparently I'm a carrier, I've been exposed to it. Mom the RN is on vacay so I don't have anyone to flood all of my questions. They say there is a medication you take, but I hate taking antibiotics and I'm afraid it will make my stomach hurt and make me sickly, and I'm about to start an accelerated nursing program! Not a good time. The RN and my Dr said it wasn't a huge deal, that both of them had been exposed to it, the only thing is your future children could potentially be carriers? I don't know how this has happened, I haven't worked in the med field yet, I worked at a car dealership and a restaurant(which is prob where it came from) The RN said she found out the same way, before she started nursing school. So I guess my main questions are, can you still start nursing school? how important is it to take those meds and what are they? and how do you just become a carrier, i mean why didn't i get TB? I know there's a difference between active TB and a carrier but how does that happen? Would I have got sick when I was exposed and just thought it was a cold? I guess the most important one is Can I still start school?! My Dr said a lot of people in the medical field were carriers but this is the first I'm hearing of it and RN mom at the beach is a little concerned too. Please help ease my mind!! Thank you

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Dont worry. Many people are carriers which means that if you become immune compromised then you may get sick with active TB. Most people get it from their home country where its prevalent, prior BCG vaccination or from family members they spent a lot of close contact with. Some folks are just more likely to get sick than others. You can start nursing school with no problem just make sure you keep your x-ray because hospitals will ask for it prior to starting. There are 2-3 meds you take for about 9 months just to ensure you dont get active disease. Lots of healthy folks take it and dont have problems. Dont worry if you are a carrier it just means that you dont have to take the PPD ( TB skin) test every year because it will always come up positive.

I worked with a TB public health nurse for few weeks and she was also a carrier no big deal.

Good Luck with nursing school

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Thank you so much. I'm just very confused right now. Especially about that medication.

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Specializes in LPN, Peds, Public Health.

If it was only red then it was not positive.

Did you actually have induration, or just redness??

And you do not have to take the meds if you do not want to. They are offered, but are not required to be taken.

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Specializes in LPN, Peds, Public Health.

And yes, you should still be able to start school. A lot of people in the medical field have positive PPD's. Really no big deal. PPD's are actually an outdated test.

All a positive means is that at some point you have been exposed to the germs. You may or may never get the disease. You can take the meds, and that will prevent it from ever becoming an active case. Or you can choose to not take the meds, and possibly, emphasis on possibly, at some time in the future acquire the active disease. From what I have heard, the Tx are not fun and are long term. I have not had to deal with that myself, but know many people who have.

As the other said, if your PPD was truly positive, you will not ever have to have another, because it will always be positive. A clear chest x-ray is all you need, then each year you will fill out a little questionaire to see if you have had any symptoms.

The CDC website is an excellent source for info.

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The med assistant said it looked positive?

Anyway, if a chest x-ray is clear, why would you need antibiotics? I ask because several years ago, I had a PPD that was falsely read as positive (this nurse is famous for saying they're all positive). So, I had to go for the chest x-ray and it was clear. But I was never offered a medication or anything even though we were operating under the assumption that I was positive. So, now I'm curious.

BTW, I've never had a positive one since that time.

As as aside, when I went to have my PPD read for nursing school, guess who the RN was? Yep, the same one that said I was positive 15 years ago. I went in, my arm was totally clear, no induration, no redness, no sign whatsoever that I had even had the test. She is feeling around on my arm, staring at it, and just kept feeling of it and asking me if I could feel anything. There was NOTHING there. Its like she is determined to find them all positive.

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Specializes in LPN, Peds, Public Health.
The med assistant said it looked positive?

Anyway, if a chest x-ray is clear, why would you need antibiotics? I ask because several years ago, I had a PPD that was falsely read as positive (this nurse is famous for saying they're all positive). So, I had to go for the chest x-ray and it was clear. But I was never offered a medication or anything even though we were operating under the assumption that I was positive. So, now I'm curious.

BTW, I've never had a positive one since that time.

As as aside, when I went to have my PPD read for nursing school, guess who the RN was? Yep, the same one that said I was positive 15 years ago. I went in, my arm was totally clear, no induration, no redness, no sign whatsoever that I had even had the test. She is feeling around on my arm, staring at it, and just kept feeling of it and asking me if I could feel anything. There was NOTHING there. Its like she is determined to find them all positive.

If you go through the state health department, which most positive PPD's are referred there (at least in my state) then they will offer the meds. I dont think they are actualy antibiotics, if they are they are ones only used to treat TB. I would need to look into and research the med protocol.

There is a huge problem with nurses not being trained properly in how to apply the test, or how to read the test. I think there should be mandatory training through the state health department for any nurse who is wanting to administer PPD's.

I have seen so many people read as positive simply because their arm was red. That IS NOT a positive!!!

Training training training!!!!

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If you go through the state health department, which most positive PPD's are referred there (at least in my state) then they will offer the meds. I dont think they are actualy antibiotics, if they are they are ones only used to treat TB. I would need to look into and research the med protocol.

There is a huge problem with nurses not being trained properly in how to apply the test, or how to read the test. I think there should be mandatory training through the state health department for any nurse who is wanting to administer PPD's.

I have seen so many people read as positive simply because their arm was red. That IS NOT a positive!!!

Training training training!!!!

It was the state health department. So, I don't know.

Yeah, I think that's what happened with mine. It was a tad red, so she automatically said positive.

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I just had the second of a 2 step TB test yesterday for school. As I read this post now I am wandering how the nurse will read my test tomorrow. The first test last week was clearly negative. This second test has resulted in a nice size purple bruise almost 1 inch in diameter. I just knew when she stuck me that I would bruise because it really hurt! I am hoping the nurse who reads my test knows what she is doing.

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I had the second step of a two step skin test, required for nursing school, done today. My first one had a nasty bruise but was negative, it was because of the way she stuck me. I work in a hospital now in research, so I get yearly skin tests.

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Specializes in geriatrics/long term care.

I have worked in nursing for years and taken many a PPD test, all negative until about 5 years ago when I took it and the area swelled up, turned red, and itched like the devil. Ended up at the state TB clinic where the nurses have a clue as to what a positive should look like. I was told I was negative, but the next year it did it again. I was sent back to the TB clinic, still negative, but with what I believe is probably an allergy to the shot which developed after years of exposure to it. I would seek out the state TB clinic in your state, they see REAL positives every day and REALLY know what they are looking for. Now I forgoe the two step PPD in favor of a chest xray

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Is it possible for you to get a repeat skin test, and then get several opinions before deciding to take the meds? In my short experience so far, a *lot* of nurses and even some doctors aren't really 100% clear on what constitutes a positive reaction, rather than just a little allergic/sensitivity kind of reaction. Redness should NOT be measured! Just the raised area... and if you have no risk factors, the area has to be 15 mm to be positive. It seems like if it were, the RN would have caught it the first time.

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