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Q: Positive Tb Test
asked by: msvangie on May 14th, 2007
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Hello, I had a positive TB skin test back in 1986. I was given the BCG vaccine when I was young. At the time I was pregnant so they couldn't take a chest xray nor could they treat me. After my daughter was born, the doctor no longer mentioned anything regarding the skin test. Fast forward now to 2007 and for the past 21 years I've never been treated with INH nor have I exhibited symptoms of TB. Well I just had a laparoscopic surgery about a week ago and the day after my surgery I experienced extreme pain in my right flank area. After numerous chest xrays, it was determined that I had a pleural effusion. They did a thoracentesis and the pleural effusion was blood tinged. Now the doctors got all excited and focused on my past positive ppd test. They wanted me to start on the INH treatment NOW! I refused. They sent the fluid to the lab for testing but the results will not be available for another three weeks. Meantime the doctors are harassing me to take the Isoniazid drug. My question is: What is the benefit of taking INH at this time since it has been 21 years since I was tested and have shown no symptoms for active TB. What would happen if I decide not to take this medicine at all? Any answer would be appreciated.
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oceanic
replied on May 23rd, 2007
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Re: Positive Tb Test
He is only giving you inh? Therapy for active tb should contain at least 3 or 4 different drugs. If you have tb, inh alone will not help much. Check with another specialist.

Tb skin tests don't make much sense for ppl who had bcg vaccination, cos their tests mostly come out positive. Go ask for a quantiferon test.

There should be some fast smear tests which can be applied on your lung tissue in order to determine whether it is tb or not. Sometimes tb tissues show pathological signs like certain enlarged cells. Although it takes weeks to grow germ cells out of the given tissue, this is the only way to determine the specific bacteria and whether they are drug resistant or not.

Does your current doctor have any experience with tb? Just make sure he is not panicking and reading tb scars into your x-ray cos your skin test was positive. Do you have other symptoms like fatigue, night sweat, weight loss or constant cough?

Not much blames on your doctor, cos tb is contagious and you certainly don't want to infect your family and friends. Once infected, the bacteria can stay dormant for decades before causing active tb. Since, nowadays, tb is not wide spread in industrialized countries, many doctors fail to read the signs or don't prescribe the right cure. Make sure you get the appropriate diagnosis and treatment. Good luck!
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