Sunday, May 31, 2009

TB or Not TB? That is the Question...

*Note: this is not my actual arm, though the picture closely resembles what my arm looks like.*
Well, in order for me to volunteer at Heritage I had to take a TB skin test. I got the shot Wednesday & the results were a possible positive on Saturday. My spot measured 13mm in diameter and has been quite itchy. I will be getting a phone call on Monday from someone to schedule a chest x-ray and I am most likely to take some kind of medication for 6 to 9 months.
What does all this mean? Well, I'm not quite sure really. I do know that if it is in fact a positive TB result that I was exposed to the TB virus somehow and my body recognizes it. I also am aware that there a "false positives" (which I'm hoping this is). I do have really sensitive skin and immune system. The other option is that I take another TB skin test (in the US they recommend doing so a week after the initial one, and the UK recommends 6 weeks later). There are varying opinions on the matter; and yet, I don't really get a say in it--it depends on what the doctor determines. What ever the decision, I'll follow it because I really want to do volunteer work there.
Here's the guidelines I found on Wikipedia for the Classification of tuberculin reaction:

The results of this test must be interpreted carefully. The person's medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive.[3] A positive result indicates TB exposure.

5 mm or more is positive in
HIV-positive person
Recent contacts of TB case
Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB
Patients with organ transplants and other immunosuppressed patients

10 mm or more is positive in (the category I'd be in)

  • Recent arrivals (less than 5 years) from high-prevalence countries
  • Injection drug users
  • Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
  • Mycobacteriology lab personnel
  • Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc)
  • Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
15 mm or more is positive in
Persons with no known risk factors for TB
So in my best opinion I'm not positive for TB. Let's see...I haven't been out of the country in over 10 years, I've never used any illegal drugs or injected myself, I haven't worked in a high risk area before, I don't work in a biology lab, I don't have any high-risk clinical conditions, and I'm definitely older than 4.
Hopefully the other consulting doctor agrees with me (I would hate to have 9 months of medication for something I didn't even have in the first place). Wish me luck!

2 comments:

  1. Good lick and I pray for the best for you. I just got a TB test done to work in a child care center. The injection site has shrunk to like a very very small mosquito bite and doesn't itch hurt or anything. I find out my results on Thursday.

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