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Tuberculosis

PPD test

08/22/2007

Question:

My PPD test is positive and the result of my chest-x ray is bronchitis. Is my tuberculosis is active?

Answer:

To diagnose “active” tuberculosis (TB) disease of the lung depends on five important factors: typical symptoms, history of possible exposure, positive tuberculin skin test or PPD, abnormal chest X-ray (CXR), and a positive sputum test.

The usual symptoms of active TB disease include fever, night sweats, cough, loss of appetite, unintentional weight loss, blood in the sputum (phlegm) and loss of energy. Usually, a person with active TB will have had symptoms for several weeks, a positive PPD, an abnormal CXR with specific findings, and a positive sputum test. On rare occasion these symptoms or tests may be negative.

Latent TB infection is less aggressive than the active form of TB disease. Your body is infected with the TB germs but they are not rapidly reproducing or spreading. The person’s PPD skin test is positive but they do not feel sick, do not have any symptoms of active TB disease, and cannot spread the disease to others. The CXR is normal. If they do not receive treatment for latent TB infection, they may develop active TB disease later.

Bronchitis is an inflammation of the upper airways of the lungs and is usually caused by an acute infection (over a period of days) or exposure to an irritant. The CXR is typically normal. Thus, the CXR for bronchitis does not resemble the type of abnormal CXR normally seen in patients with active TB disease.

Because your PPD test is positive and your CXR is abnormal, you should be evaluated by a doctor to make sure that you do not have active TB disease. Depending on your symptoms and risk factors your doctor may order additional diagnostic sputum tests to help with the diagnosis of active TB disease.

For more information:

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Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University