Advice about TB Tests
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Advice about TB Tests
April 1999
Our daughter has tested positive (14mm) to a TB skin test. We are both
negative and can't figure out where she could have been exposed. She
does not have TB and a chest X-Ray was normal. We are even wondering
if this is a false positive, which are not uncommon. It has been
recommended that she take the 6 month course of Isoniazid. Has anyone
had this experience or treated active TB with this drug? How did your
child fare? Any tips on getting two large pills down a 5 year old
everyday? Thanks.
About ten years ago I also tested positive for TB (skin test) but my chest
x-ray was fine.
I did not have TB, but my doctor at that time (a new grad from medical
school I think) prescribed some pills for me which I was told would
have some side effects with the liver. I never took those pills. My
pediatrician who had worked in Asia told me
that many people from Asia had (chicken pox? I don't remember )
immunization shots when when they were young -- which is exactly my case--
and would test positive on the skin test even though they do not have TB. I
wonder if your daughter's situation is the same. If you like, I would be
happy to give you the name of my pediatrican -- just email me through this
list).
I know nothing about TB, but I have LOTS of experience with giving
medincine over a prolonged period to my daughter (unfortunately). I'd be
glad to give suggestions about giving your child the medication if you chose
to go that route. Also, it is possible to get any medication flavored to
make it tolerable to kids. A pharmacist on the East Coast developed very
strong syrups that mask the flavor of practically any medicine after
struggling to get lots of bad tasting medicine down his kid, who has
epilepsy. There are pharmacies in California that will mix up your kid's
medicine in this syrup and fedex them to you. I can find the number for one
of them, if you'd like it. (I think these syrups are used at the pharmacy at
Fresno Valley Children's Hospital.)
False positives can certainly happen with TB. But if you don't know where
your child was exposed, it would be good to double check her possible
sources, such as day care providers, other sitters, etc. I would get
another opinion before starting on a course of isoniazide, because many TB
strains are resistant to that drug. You can contact Children's Hospital in
Oakland, where they have a specialist in pediatric TB, Dr. Ann McLaughlin.
She is well known for her expertise and has access to other professionals
who work in the area of TB, so could get others' input if necessary.
Which kind of TB test did your daughter take, the one we all had as
kids (quick scratch on the surface) or the mantoux (needle under the skin, a
more expensive test)? Dr. Ralph Berberich, my son's pediatrician, says that
recent studies have shown that the old test has so many false positives and
false negatives that it is worthless and shouldn't be used. The only
reliable test, he says, is the
mantoux. He cited medical organizations/agencies that shared his view.
If your child had the discredited test, perhaps you don't need to be
worrying how to get pills down a 5 year old's throat.
To the parent concerned with his or her child's positive TB test. Has your
child ever traveled out of the country, and received an immunization shot?
The reason I'm asking is because, coming from Peru as a child I was
administered a shot that always counteracts with the antibody found in the
TB shot. I have always shown to be positive, and after about 5-6 tests,
chest X-Rays, and taking those
nasty pills, my doctor decided it was not necessary for me to be exposed to
such things. My body was purposely exposed to the causing agent, but never
had the reaction. From this day on I will always test positive in my TB
shots, but I was warned by my present doctor not to allow anyone to
administer the TB shot because it was doing me more harm than good. I don't
remember the name of the immunization that I was given, but I am sure that
your pediatrician is aware of
it.
A doctor once told me that most native Filipinos and Latin Americans will
show a positive TB result, only because of the immunization given to them at
an early age. This in no way shows that they have ever had the infection.
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