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Thursday, April 24, 2014
Latent TB treatment
I was recently tested for TB after a fellow employee came down with active TB. 70 people were determined to possibly be at risk but only 14 of us were identified as being at the most risk. Depending on the results of the first 14 they say, will determine if the others will be tested. But out of 3 results back so far, I was the only one to test postive. The chest X-ray was negative and I was told I have latent TB. I was also told that the employee has active drug resistant TB. I`m an otherwise healthy 45 year old male. If I do the treatment, what can I expect with a possible drug resistant TB and what are my chances of being cured? What about a false positive? Should I ask for the Quantiferon test to be performed too?
You don't mention whether you have ever had a positive TB skin test previously, or if you ever had the BCG vaccine, or how large the diameter of induration of your current PPD was, so I cannot be certain that you are infected with TB because of exposure to your co-worker. However, in general, properly placed and read PPD skin tests perform quite well in detecting newly TB-infected persons in contact investigations. I am not aware of any evidence that Quantiferon-Gold blood testing is superior to PPD skin testing in a contact investigation. There is little clinical information to guide decision-making regarding treatment of latent TB infections in persons exposed to multiply-drug-resistant TB. You should speak with your local TB clinic about what drugs the TB you were exposed to is resistant to and, if the TB organism was multiply-drug-resistant, about getting advice from your regional TB center.
Lisa A Haglund, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati