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If your wife had the TB vaccine (BCG), she should have a positive PPD because her body was exposed to the bacteria through the vaccine and thus developed antibodies to it. A lot of people in the military get the vaccine and will have a positive PPD as that is the expected response.
The TB vaccine is not regularly given because it's not very effective and lasts for only 15 years. This why the general public doesn't get it but the military still does and some foreign countries still give it.
The way the PPD test works includes the following: a small amount of antigen is placed just slightly under the skin. Your own body's antibodies react to this antigen. This antigen-antibody hookup forms a reaction that creates a red raised bump. Antigen is a piece of the TB bacteria. The PPD stands for Purified Protein Derivative. It's not live. Think of it like a piece of the bacteria that is cleaned and processed. It can't cause disease but can do enough to cause your body to produce antibodies to it.
Many PPD tests are often misread because people will falsely measure the redness and if the redness exceeds 5 mm regardless if its flat and soft, they will read that as positive. The redness does not mean it's positive. It's the induration that defines it. Induration is how high and hard the bump is. If it's flat and soft but red, that's not a positive test.
Yes, your girlfriend should see a physician and be given a Chest X-ray. The approach to dealing with TB is to start with a PPD test. If the test is positive then a repeat test is done. If that is positive, a Chest X-ray is ordered. If the Chest X-ray is negative, you will be started on antibiotics for 9 months. If it's positive, the patient is placed in isolation and given a course of antibiotics. Most health care professionals are automatically given the test and repeat test. There is a difference between active TB and latent(dormant) TB. You had latent TB and were given a course of antibiotics for 9 months to kill it so that you don't get active TB. Active TB will show up on Chest X-ray. The reason your girlfriend needs a Chest X-Ray is because she had the vaccine so her PPD test is useless since its expected to be positive that won't tell us anything about her. However, she could still have a positive chest X-ray if she has active TB and that needs to be evaluated since she was exposed to you and the BCG vaccine is only effective for approximately 15 years. Close exposure to a person who had a recent positive PPD usually warrants treatment for 9 months too.
Last edited by azriverfan.; 05-27-2010 at 09:50 AM..
A question for you folks who actually give the injection - do you mark the site on the arm so that the area can be easily pinpointed for reading? If you mark it somehow, what do you use?
I never marked it. I just record where the injection was done. If it was positive it would be hugggge, can't miss it.
There's no effective vaccination for adults, BCG vaccine is semi-effective versus pediatric TB and some non-pulmonary TB. And yes, prior BCG vaccination can create false positives for the skin test. I don't remember from where, but there was a study suggesting half of all military positive skin tests were false positives. Pretty much any exposure to NTM would cause false positive since the PPD is so non-specific.
I recommend getting the QuantiFERON Gold blood test, which does not bring in administration and reader error unlike the skin test. Also this is very good at catching latent TB as well. I see a number of cases of MDR-TB so the blood test is what I get.
Of course a previous vaccination will give a positive test!
They aren't false positives. The test is designed to show whether there has been exposure to TB and the vaccination exposes you to TB.
All healthcare workers in the US are checked every year as far as I'm aware.
I had a CT-Scan and my Dr said I have TB in both lungs I am not sure what to expect, I have had blood work, all came back good, I have had to spit in tube for 3 days no results yet, I have taken a tb skin test 2 days ago but can barely see a slight redness and bump, I have pain in my lungs and cough that comes and goes I am not on any medication and this is my concern, they tell me I am contagious but I have had to wait 2 weeks to see a pulmonary specialist. I live in South Korea and they tell me it is better that I stay here for treatment but that it will take 6 month or more. I don't know what to expect with this disease or if I really have it. Scared and Confused please reply
I think they must have seen something in your lungs to make that diagnosis. You would be prohibited from entering most countries until it is treated. Your symptoms sound painful. You can get treated and recover.
i have ppd test a week ago and accidentally touch it when itch,when i come back for reading after 72 hours i've been told i am positive but my chest x ray is essentially normal and all my blood test are ok . now the Israel embassy want me to get a second test to make sure if they will grant me a visa.I always had my medical exam every 6 months and always clear on my chest xray.this is my first time to take ppd test and my reading is 2cm.my question is do i need to get a second test? please help me as i need to get a visa to get this job for that is waiting for me in israel.by the way i am living here in taiwan and working as caregiver
hi ihad a skin test and now its on my 3rd day i noticed that i had a redness around the injected surface but swelling is not there.. it looked like a mosquito bite... and thid worry me alot if i will be having a possitive result. this would endanger me to get a working visa in Dubai.... KIndly help me extract info on skin test reading...
hi ihad a skin test and now its on my 3rd day i noticed that i had a redness around the injected surface but swelling is not there.. it looked like a mosquito bite... and thid worry me alot if i will be having a possitive result. this would endanger me to get a working visa in Dubai.... KIndly help me extract info on skin test reading...
Redness alone does not mean the test is positive.
A positive test requires a firm bump under the skin (induration) which measures over one centimeter.
If the area feels flat, it is not positive.
It is important for the test to be read at the correct time. It should have been done at 48 hours. Did you do that?
Wow I can't believe I am reading this! It's like I wrote this myself! I too tested "positive" on my birthday believe it or not...I've never had this reaction before...I don't know that happened. The test site broke out in an itchy rash like area with blisters all around it. I was already being treated for Valley Fever and was on a medication with horrible side effects but was getting sicker so my infectious disease doc tested me for TB and based on his inconclusive results I'm now on another medication thats harmful to my liver to keep me from getting full blown TB and no other doc will test me to see if I really have been infected or not because they say my arm can really become inflamed if I do test positive. Well I'm ready to take that risk rather than damage my liver on this med I don't need. So I went to the health dept today and was retested today. I should have a definitive answer in 2 days :-)
My daughter is going threw the PPD testing now. She had one done and it came back normal she just got the second one and this one has a raised lump and red about the size a quarter? Can she have 1 done and it be normal and then a week later have another one done and have a positive? I don't know if it matters that they did it in the same arm as the first one or that they did them so close together? Any ideas on this?
Worried mom
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