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Tuesday, January 27, 2015
TB Testing In A Highly Allergic Child
I have a 5 year old child who has developed a chronic cough in the last month. My pediatrician wants to test him for TB, since there have been some reported cases in our community (we live 90 miles from the border with Mexico). I am concerned about an allergic reaction to the TB skin test. What alternatives can you suggest?
The PPD skin performs well as a screening test to identify persons (including children) with tuberculosis infection or disease. Occasionally a person with TB has an unusually large reaction that is called an "allergic" reaction, but that doesn't change the interpretation that the PPD skin test is positive and that the person is most likely infected with tuberculosis. The only contraindication to PPD testing is having had a positive TB skin test in the past. The other alternative screening test for tuberculosis is a blood test, and you would have to talk with your pediatrician about the availability and cost of this test. I hope you are able to find out what is causing your child's cough in a timely fashion.
Lisa A Haglund, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati