Advice about TB Testing
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Advice about TB Testing
My 21 year old daughter had a routine TB test for a job.I was shocked when she
tested positive.She then had a chest X-ray which was clear.She was told she has
latent TB and that over 90 percent of people will not go on to develop active TB.She
is also not contagious as long as it remains latent.I read on line that one third of
people world wide will test positive and have latent TB.It was recommended to her
that she takes certain strong antibiotics for a nine month period and then she will
no longer have latent TB in her system.While taking it one needs to be monitored for
liver damage.What if she does this and then somehow gets exposed again and is latent
again without even knowing?It seems like side effects of taking this medicine for 9
months makes it not a reasonable thing to do.We have no idea how she was exposed in
the first place as she has never been out of the country or in any high risk
situations.I would love to hear from others who had positive tests and what they did
I was in the same situation in my mid-20s (about 10 years ago) and decided to do the 9 months of
antibiotics. I have mixed feelings about it. As a public health worker (ironically I was about
to start grad school for my Masters in Public Health when I got the positive result) I
understood the rationale for doing the antibiotics (INH). Basically, a healthy person can
contain the bacteria and not develop active TB but if you become immunocompromised (chemo, HIV,
another chronic debilitating illnes), the TB can become active and then you'd need to do 1 year
of even more toxic drugs while you're dealing with whatever else is going on. I opted to take
the meds and kill it while I was healthy. I have mixed feelings about that decision because I'm
now dealing with fibromyalgia that I'm pretty sure is related (my symptoms started around the
same time I started the drugs). I'm now doing some intensive alternative medicine to try and
deal with this since Western medicine doesn't have crap to offer for fibromyalgia. My main
recommendation would be for your daughter to work with an alternative medical providers
(Ayurveda/Acupuncture) to support her liver through the process. All my symptoms now are
consistent with liver issues (I've never been a drinkers, never had hepatitis, etc) and it's
pretty clear to me it's from the INH. Happy to talk more offline.
The same thing happened with my daughter when she was about 9 years old. She did take the
medication for 9 months - her doc was adamant that the 10% risk of getting TB was too much or a
risk to take with her life long health - that having it erupt latter in life would have big
consequences for her quality of life. It also becomes a public health issue - a public health
nurse was notified that my daughter had tested positive and she called on a regular basis to
make sure she was still taking the drug). My daughter did have to have some blood tests to
monitor liver function - no problem there. She does have some funny immune-response reactions
though - will never know if that's just the way she is or if the drugs could have caused this
(it is a potential side effect).
We have paperwork to document that my daughter's chest x-ray was negative and that she took the
med - we have to produce this for every new transition that requires proof of immunization etc.
She will test positive for the rest of her life.
As far as where she picked it up - we will never know for certain, but I am sad to recall that
one weekend we contacted a day labor organization for help with deep cleaning of the house - the
woman who came was obviously very ill, coughing and coughing and coughing - we felt terrible,
brought her beverages, asked her to rest, eventually told her we were fine, that she could go.
Our health nurse reported that it could have been then (although normally, you need to be in
tight quarters for a period of time, or, in any region where there's lots and lots of people
from all over the world with different health protocols, there is more risk of exposure.
The one other thing, in retrospect, that I would have done is have her re-tested - sometimes
there can be false positives with a TB test.
committed to the health of the community
I worked as a TB educator for years and my husband had a surprise positive TB test a few years
ago so I know quite a bit. First for those out there who do not know a positve TB test means you
have been exposed to TB, that your body walled off the infection and you DO NOT have active
disease as ruled out by the chest x ray. You CANNOT spread it to others but you can at some
later point develop TB disease. In your daughter's case, while it is true that she does not have
TB there is substantial risk that when she is much older or if she develops any type of severe
infection or chronic illness she could infact develop TB. While the drugs she would take to
illiminate the TB infection are harsh, at 21 the risks are minimal and the drugs are MUCH less
harsh than if she one day develops active TB. The monitoring is thorough and if any problems
develop related to her liver function they can be discontinued and her liver will recover. The
benefits of taking the medication to illiminate the infection at her current age and good health
should not be underestimated. Her liver is young and healthy now and the drugs will prevent the
possibility of TB later when she may not tolerate the drugs as well and her life and health may
be compromised. When you have active TB you take multiple drugs for a minimum of 18 months. At
this poiint she will only need 1 or 2 drugs for 9 months. Please encourage her to do them now.
In my husband's case his positive test came at age 41. After age 35 the risks to the liver
increase dramatically. He did try to do the drugs but his liver could not tolerate it. Now he
will be TB positive for the rest of his life and there is always the possiblity of he will
develop TB! If you want more information I highly recommend contacting the TB clinic at the City
of Berkeley. They are extremely knowledgeable and will answer all of you questions.
better safe than sorry
Hello. After living abroad (Spain), I came back to the States and had a positive TB test. That
was 20 years ago when I was 18. I had a chest x-ray, which was clear. I was put on an INH
treatment (pills). It was not a 9 month long treatment, but it was many weeks or maybe a few
months. I do not remember it being threatening to my liver or being monitored for adverse side
effects. I am wondering if alternate treatments are available to your daughter that have fewer
side effects. Or, perhaps the science that treated me is old. I was told that I will always
test positive for TB, so throughout my life since then, when a TB test was required, I have been
required to get an updated chest x-ray. It's a hassle and expensive, but it's not rare. I hope
there is an alternate treatment out there for your daughter.
I would get a second opinion on this, because that regimen of antibiotics seems too extreme,
esp. since her chest x-ray is clear. My husband (a teacher) tested positive for latent TB over
18 years ago (he was probably exposed during an extended stay in eastern Europe). Once his chest
x-ray came back clear, that was that-- no antibiotic treatment at all.
If she has only had the Mantoux test (the skin prick) she should also give a blood sample and
have an interferon gamma release assay (IGRA) run on it. This will rule out a possible
false-positive result from the Mantoux. There are certain underlying conditions that can cause a
I would not worry about it too much. Many people turn positive in the course of their lifetime
and most of them opt not to take the anibiotics course. As you said those are strong
anitbiotics with harmful potential side effects.
I would also make sure that whoever read the positive test is an experienced reader, ie somebody
who routinely reads 100s of those tests, not your local primary care. A reddened area is
usually not considered positive unless it is clearly swollen/raised.
When I was about 20 yrs old, I applied to volunteer at the Berkeley Free Clinic and tested
positive on a TB skin test. My chest xray was negative and I took antibiotics for the prescribed
amount of time. At the time, I was delivering meals to AIDs clients as a volunteer. It was
possible that some of the clients had TB. Anyways, I'm in my mid-30s and work as a nurse now so
I'm screened every year for TB. Since I tested positive in the past, I will always test positive
in the future so I'm not required to do a skin test. Instead, I'm supposed to get chest xrays
every few years. However, employee health told me if I'm not showing any signs/symptoms of TB,
xrays aren't needed that often because of the risks from radiation exposure.
Hope this helps
I had a positive TB skin test years ago. I also had an x-ray, which proved I did not have TB.
A positive skin test just means that you were exposed to the bacterium, not necessarily that you
had TB or are infectious. Taking meds for a positive test is routine in case the TB is latent,
and in the rare chance that it will turn into full-blown TB. I did take 6 months of INH, and I
had no side effects. The pills were kind of large, but other than that it wasn't a big deal for
My current boss, who is a physician, told me that the skin test result I had was likely a false
positive. I don't know why he thinks that, but that is another possibility. I wouldn't worry
about it. Your daughter should probably take the meds just in case, so that she can be done
with it. Also, in case she ever wants to volunteer with kids, a negative TB test or treated
positive with clear x-ray might be required (it is in my son's school district). They were not
phased at all by my history of a positive test, since I did the routine x-ray and INH treatment.
I tested positive for TB several years ago during a required yearly TB test because I was a
regular volunteer at a school. All of a sudden it went from ''normal'' one year to ''big raised
bumps'' the next. I also had no idea where I had been exposed but my primary care physician said
it was very common in the Bay Area (working with kids, riding BART, traveling on planes were all
mentioned as possible exposure means). My chest x-rays have always been clear. My doctor
recommended I complete the antibiotic course before I turned 50 (I first tested positive in my
late 30s) because the chance of getting tb in my 70s would be much increased and harder to
treat. I was also concerned about getting antibiotic resistant tb in the future.
It took me a few years before I was ready to do the drug therapy but I completed it about a year
and a half ago. My doctor felt that 6 months of antibiotic therapy (isonaizid in my case) was
adequate (I believe there was some recent research that indicated most of the benefits were
obtained with a six month course with only minimal gains for continuing on the drugs.
I did baseline liver testing before beginning the drugs, tested again a month into it and at
completion. It is important to do the liver tests if you have certain conditions or drink
alcohol (which you can't do at all on the drugs)
Once you have latent tb you will always test sero positive on the skin test. I get a chest x-ray
when needed. My doctor has also provided me with a letter that indicates I completed the therapy
course and had clear x-rays. While I was on the treatment at least five friends told me they'd
also tested sero positive and completed the treatment.
Hope this helps.
been there and did the abx
So sorry to hear that you and your daughter are grappling with this decision.
If your daughter goes without preventive measures and does develop TB, her illness could well be
very serious. She would also pose a serious risk to those around her (think your grandchildren
in the future!). The preventive and treatment measures are better tolerated in younger people,
so that should be taken into account. It is not nearly so likely that a 21-year old would be
exposed in the US as in many other regions of the world, so if she has spent time in a region
with endemic TB, that may be an explanation for her exposure. In most US populations the chance
of reinfection is quite low. Please encourage your daughter to talk to her doctors. Also, do
get multiple opinions if you are not convinced that a well-monitored preventive course is at
least a reasonable course of action. There is risk either way, so keep asking questions.
Just a few resources that could provide information for you.
In general everyone should note that prevention of TB is a public health concern, and resources
do exist to treat those who cannot pay.
Not a medical doctor, just concerned.
Did she get a blood test or a skin test? If she got the skin test, ask for a Quantiferon blood
test. Some private practice doctors who don't see much of a high risk population for TB may not
be using it as much as they should. It's newer and more expensive but more reliable than the
skin test. If she has no known exposures and it was just a positive skin test, then most likely
the Quantiferon will be fine. If she had a positive Quantiferon then she's best of taking the 9
months of medication. Yes, most people who have latent TB don't progress, but a 10% risk of
progressing to active TB is substantial. The risk of dying or having permanent disability from
letting latent TB potentially progress is worse than the risk from taking 9 months of INH --
particularly for a 21 year old, as the risks of INH are lower the younger you are.
doctor at an immigrant clinic
Our son took TB test as part of college admission and also to our surprise tested positive but
was also latent (rest of family got tested and no one else tested positive - he could have been
coughed on anywhere!). The issue is that while healthy people are highly resistant to
developing full blown TB, anyone with compromised immune systems (malnutrition, autoimmune
illness, chemo/radiation) are HIGHLY susceptible. And you can have active TB and not know it
(hence who knows where your daughter/my son was exposed). By the way, if he hadn't taken the
drug protocol, he WOULD NOT HAVE BEEN ABLE TO RESIDE IN THE COLLEGE DORM! So its as much a
public health issue as well as a personal health issue (your daughter's health status could
change, lupus, mono, all kinds of autoimmune illnesses could activate the TB virus). For
evermore, he will test ''positive'' and will have to have doctor's ''note'' that he
successfully completed the drug regimen in order to negate the positive test. Many jobs
require TB testing (especially food, teaching professions) and either a negative or a ''proof
of regimen completed'' is required to have the job. In terms of the regimen's safety, one very
important issue is NO ALCOHOL can be consumed during the 9 month regimen (and the drug must be
taken regularly or the TB virus just becomes resistant). This was impressed upon our son - he
successfully completed the regimen without any issues and just has to deal with always having
to explain a positive TB test.
I didn't see the original post, but I want to second what one person suggested about the
Quantiferon blood test. I tested positive in a TB skin test, and was told by a Kaiser doctor
that I needed a chest x-ray and antibiotic treatment for months-- this was causing me all kinds
of stress since I have a history or allergic reactions to antibiotics and am breastfeeding
currently. Long story short, a simple blood test showed that the skin test was a false
positive-- I had never been exposed to TB at all. I am SO GLAD that an alternative doctor
suggested the blood test- saved me a lot of stress!
I missed the original message, so I'm not sure about the age of the child that tested positive
for TB. If your child is 5 years old or younger, please understand that the risk for
progression from latent TB to TB disease is significant.
From the CDC:
''Because of their age, infants and young children with a positive TST reaction are known to
have been infected recently and are at high risk of rapidly developing TB disease. Infants and
young children are also more likely than older children and adults to develop life-threatening
forms of TB disease.''
The advice of previous posters suggests that a decision to treat your child for latent TB is
made on the basis of protecting him/her from disease in adulthood. It is true that latent TB
can progress to TB disease many years after infection (especially during periods of stress or
other illness), but children can and do develop TB disease! Get advice about whether to treat
your child from his/her physician and the health department.
A Public Health Professional
Looking for recent experience with a positive TB test in a very healthy child (age 10). Our doctor
wants to treat with antibiotics ( a 9 month course) even though a chest x-ray shows no sign of active
TB. The rest of the family is in the process of getting checked out. I have a consult set up with
an infectious disease doc, but was looking for any other parental views on this. Just not
comfortable yet moving ahead on the treatment. ANy thoughts/good resources to consult with on this
issue? I am told it is not that uncommon but the news really threw me.
Sign me..cautious about treatment
The same thing happened when my very healthy daughter was 9 years old. A positive
TB test just means that she was exposed to someone who had an active case of TB.
In the bay area, sadly, this is not that unusual. We traced her exposure to a woman
who cleaned our house.
The x-ray is to rule out that your daughter has TB. If she does not take the
medication, there is a 10% chance that she will develop TB at some point in her
life. Often, the disease will surface when the body is placed under extreme
stress, the person is immuno-suppressed, or when the person is elderly. TB is a
life changing, potentially life threatening disease.
Even though we weren't thrilled about putting our daughter on the meds, we decided
that the disease risk was unacceptable. Also, we were surprised by how worked up
people get about the fact that your child had a positive TB test. A lot of people
did not believe that she did not have TB. It's nice to have a letter from your
doctor saying that they do not have TB, have been x-rayed and undergone
preventative treatment to put school officials at ease.
Now it's ancient history and we've moved on. Good luck with your decision.
It's always something, isn't it?
Hi. I was also told by doctors at L. Packard that the chest x-ray would not show
anything. So, they opted not to do one and just have the TB test redone for
confirmation. To be honest, I would prefer to have the treatments rather than
complications later on.
I have knowledge about TB, although I am not a physician so you will have to talk
with them to make the final decision. This is standard for a positive TB test.
Most people who pick up TB don't show active symptoms right away (fever, coughs,
etc.). Instead, the TB goes dormant and sits in the body until the person is
really stressed out and the immune system is compromised in some way. Then the
person gets full-blown TB. This could take two, five, ten or more years. If it is
not a drug resistant strain (most US strains are NOT drug-resistant), it can be
easily treated, but it can be a dangerous disease for an unlucky few who get a
worse version of the disease (very rare) and it is highly infectious to others.
So, when a person has a positive test, they most likely have dormant TB (also
called latent TB) so the standard procedure is to go on the anti-biotics for nine
months. (I did this too about 13 years ago. Never had any side-effects from the
medicine, which is the same drug they still use now.) Children do better with the drug than adults.
It's the older adults that need to watch their livers, etc. but kids do great.
Just don't use tylenol during the treatment (use motrin instead which affects the
liver much less). This is standard procedure and safe. You really don't want your
kid developing TB later. TB is initially scary to most people because it is a
weird and complex disease, but the CDC guidelines for this disease are smart and
safe. To tell you the truth, my 3 year-old is on the same drug now and I have a
PhD and have researched this and I'm OK with it. (He was exposed at daycare.)
Should you decide to go with the treatment, make sure your son takes the drugs for
the entire nine-months or else drug-resistant TB could result. health depts are on
top of TB because there are drug-resistant strains outside the US. The strains in
the US respond to drugs and the CDC wants to keep it that way and protect our
TB is weird but we are OK in the US
I don't want to give you medical advice so please don't take it that way, I am just
sharing my experience. When my son was younger, the clinic we took him to did a TB
skin test every year at his checkup (even though he has no risk factors for TB).
When he was four, they said that the skin test was positive (didn't look positive
to me, but what do I know). The chest x-ray was negative, but the doctor wanted to
put him on INH (the antibiotics)anyway as a preventative measure. I was very wary
to put him on those antibiotics because they PERMANENTLY impair your liver function
- a fair price to pay ONLY if you really have TB. So I made a fuss and had them
redo the TB skin test. They didn't want to do it because they said every time you
repeat the test, you increase the chance of getting a false positive, but I
insisted (A question I didn't think to ask until later - If repeating the test
increases the chances of a false positive, why are you testing todlers EVERY
YEAR?). The repeat test came out negative, and I had them write a note on his immunization
card to STOP doing the TB skin tests. I have since found out that it is not
standard practice to test a child with NO risk factors for TB, and that TB skin
tests are notorious for giving false positives. I think I have heard that there is
a more reliable test for TB, but I don't know what it is called or how to get it.
My advice is to be very cautious, my experience in general is that doctors are
liable to overtreat.
No more TB tests for us
I was in the same position about 7 years ago. My healthy 10 year old had a
positive TB test and negative chest x-ray. I agree with previous posters,
please have your child take the treatment, don't let this become an active
case of TB. 9 months feels like a long time but it's a blip over the course
of a lifetime, and worth it to avoid a preventable disease. Permanent
impairment of liver function is NOT a normal side effect of the medication.
It's true it MIGHT affect the liver, but part of the treatment protocol is
to have a blood test part way through the treatment to make sure the liver is
functioning normally. If there are problems the course is discontinued. My
child did not have problems with the treatment, and I hope your child will be
fine too. Good luck.
My 12 mo. old recently had a TB skin test. Twice I was told
that the results were positive at 10mm. The third person said
it seems to be 8mm- which would be a negative result.So, they
went with the 8mm and advised that there would be a retest at
some point. Now, I am uncomfortable and wondering if this has
happened to anyone else? Any advice would be appreciated.
Not sure if this answers your question directly but...
You might want to check with a doctor from Infectious Disease
(at Children's or elsewhare). A positive PPD is measured by
the size of the ''bump'' (not what is simply visibly red) and
there is a range of what is considered positive. ''TB Tests''
are really PPDs that test for a reaction to a variety
micobacterial infections- not just Tuberculosis. My son is
recovering from a non-tuberculosis micobacterial infection
characterized by swollen cervical lymph glands. The infectious
disease group at Children's Oakland figured this out by placing
a PPD which came back positive, and we had pretty much ruled
out the real TB. Your regular pediatrician should also know
all about this, however. I'm curious to know why he had the
PPD in the first place?
Our 2.5 year old son was born in Mexico and routinely given a TB
test the day after he was born. As he prepares to enter a
California pre-school, he has tested positive for tuberculosis,
though his chest x-ray shows a negative result for the disease.
A doctor prescribed a nine-month course of isoniazid taken
daily, to satisfy state education authorities that the boy's
condition was under treatment. However, after reading the
catalog of side effects (including liver damage and hepatitis)we
are concerned that the ''cure'' may be worse than the ''disease.''
Does anyone know if alternative therapies exist for inactive TB,
and/or whether a physician's statement that the treatment is
excessive and unnecessary would satisfy the authorities?
Finally, does anyone know a good pediatrician who is willing to
consider alternatives to standard overkill treatments? Many
You may want to talk with Dr. Salzburg, of Kiwi pediatrics. We
talked to her about TB and she told us about how US guidelines
(specially re: school policies) are not up to date with research
and about the cons of treating TB in children when the X-rays do
not show sings of TB.
Their practice phone number is (510) 652-1720 (Alcatraz office,
they also have an office in Albany).
I go to Pediatric Alternatives in MIll VAlley 415-380-8448, run
by two western trained women pediatricians. One is also an
herbalist, the other a homeopath. I would give them a call to
find out what they can do for you.
best of luck.
Please, please reconsider doing the course of treatment with
Isoniazid for your son's positive TB test. The positive test
means that he has been infected with tuberculosis bacteria and
they are living in his lungs. A 9 month course of isoniazid
(once daily) will eliminate the bacteria and prevent him from
ever getting tuberculosis. If you do not do the treatment,
there is a chance he will develop active tuberculosis, which
requires FIVE medications for an extended period of time, and
the risk that he could develop disseminated disease and have
long term complications. This is not something you can treat
in other ways...I wish it were. I am speaking as a physician
who has taken care of many, many children with positive TB
tests and I can say that the complications/side effects from
the medication are very rare...children actually tolerate the
medication much, much better than adults do, and most have no
problems at all with it. Please do your child this favor.
I sympathize with you. Our daughter also tested positive, when
she was just about to turn 4, and had a negative chest X-ray. I
really agonized about putting her on the INH treatment regimen,
and did a fair amount of reading on the subject. Our group of
pediatricians were not very helpful or knowledgeable on the
subject, and gave some conflicting opinions and advice. In the
end, we went ahead and did the INH treatment, although only for 6
months (which was fine according to our new pediatrician).
Currently the standard protocol is 9 months. The side effects
you mention are really an issue only for adults; young children
rarely experience them. And you can ask for periodic blood tests
to be sure. I guess what persuaded me was the risk of developing
full-blown TB as an adult, which would be so very much more
serious than taking the medication now. Our daughter did have
some problems with the liquid medicine--which at first caused
explosive diarrhea. Web readings suggest that it is the sorbitol
in the liquid that causes such problems. Many people preferred
to use the pill form for this reason, and break it up and put it
in food or juice. Good luck with this unpleasant situation. If
you do decide to go ahead with the INH treatment, just know that
the 9 months will pass much quicker than you think it will!
My child also tested positive and was prescribed a full dose of
INH. I felt that it was a false positive since he was given a
TB ''vaccination'' at birth- dead cow antibodies to TB - required
by the WHO in the country he was born in. I was totally panicked
after reading the INH side effects too.
After talking with several doctors (and friends who specialise
in public health and community health issues) I decided to give
the full course of INH to my child. The information that made me
feel this was the best choice for me was:
1) The medicine-induced Hepatitis is an effect that is not
mistakable and is remedied immediately by not giving more INH.
The symptoms are immistakable and not vague: extreme fatigue
(like lying down and refusing to get up), dramatic yellowing of
the skin. These symptoms will go away within 24-72 hours of
stopping the medication.
2) Impact to liver -- the most dramatic being the hepatitis --
can be mitigated by alternative treatments. I recommend seeing
3) Once the INH course is completed, he will have a super
immunity to TB given that he has produced his own antibodies to
having the virus present (ie the positive test) and the INH has
killed the actual virus. This is important since most likely he
will travel to areas with high risk of active TB exposure.
4) If for some reason his immune system becomes surpressed in
the future, we will not have to worry about the TB choosing to
activate itself at that time. Fighting the TB virus now when he
is young and strong is the optimum situation for eliminating the
TB virus in his system.
5) The medical community has to assume that a positive test
equals a real exposure to active TB - which was a possibility in
our environment. If there was a real exposure, then our child
was in fact producing antibodies in reaction to the TB virus in
If you refuse to fill the prescription, you will be hounded by
the public health officials whose job it is it follow-up and
make sure you are complying...I was called repeatedly and felt
like I was treated in a very patronizing way when I made it
perfectly clear that I was under a doctors supervision and was
complying with treatment plans.
TB is a growing concern in the Bay Area and they are on high
alert. One issue of concern is that if a kid tests positive,
they assume it is from exposure to active TB in an adult. It is
their job to find that adult. In our case I was sure that if
there was an exposure, it was from people in another country
(the entire immediate family and siblings tested negative). This
did not placate them.
I would recommend doing something to address the negative impact
of taking such a strong antibiotic for a prolonged period. Read
The Yeast Connection.
Make sure it is noted in your childs yellow vacination booklet
that they received INH treatment - since this may come up again
in the future.
We did fine and had no noticable impact with the INH. I learned
that several other kids in the class were taking it too.
Unfortunately, the thing I want to know the most I cannot
verify, which is, if there was TB virus is it now eliminated.
Good luck making your choices!
Been there too!
My mother was exposed to TB as a girl (in another country) and
it was inactive most of her life. How I wish she had received
the ''overkill'' treatment at some point! Her inactive TB was
never treated until it was too late. She was put on prednisone
for another condition in her sixties, and it apparently lowered
her immune system so that her inactive TB became active. She
developed tuberculous meningitis and went into a coma rather
suddenly. She was put on all the medications, but it was too
late. She died without ever waking up, before I had a chance
to say goodbye.
TB is a really virulent disease that can strike at any time if
it is inactive. For the sake of your child's future, please go
through with the isoniazid treatment. I can't tell you how
agonizing it is to watch your mother die and to know that the
proper treatment existed, and that my wonderful mother would
have been alive today if it had only been given sooner.
Still missing her...
My husband tests positive for TB because he was exposed to Valley
Fever while working as an archaeologist. In Arizona this is
commonly known as a reason for a positive, symptom-free TB test.
Maybe your child has been exposed to Valley Fever instead?
I'd get a second and third opinion before I did medication for a
disease your child may not have.
Gosh, I just had to respond. I felt I needed to make a number
First, You say you believe the TB is inactive. TB is very slow
growing. Just because there is no X-Ray evidence does not mean
that it is inactive. It has been active enough to cause his
skin test to react. It is fortunate that it has not caused
active disease in his lungs yet. If you wait long enough
without treatment, it will appear in his lungs or some other
Second, In my opinion, TB is much worse than the treatment. It
can cause permanent lung damage, it can infect many organs in
the body and it can and does cause death. Even today, people
die from TB. And there are new and drug resistant strains of
TB. (The resistance has been caused by people ending their
treatment early and allowing the most resistant bacteria which
are still alive in their bodies to multiply and spread.)
Third, I understand that the list of side affects from the
medication is frightening. However, it is important to
understand that the vast majority of people who take this
medication never experience these side effects. Discuss with
your child's doctor the incidence of each side effect, or the
ones you are most concerned about. This may provide some
Finally, I would ask for information about the kinds of side
effects that are most common in 2-3 year old children. Children
react differently to medications compared to adults and the
side effects listed for a medication usually refer to adult
I don't discourage your looking into alternative treatments,
but I encourage you to thoroughly consider the advice of your
physician. Be aware that the medical community has
extensive experience treating this disease and there has been a
lot more recent work on treatments, since the drug resistant
strains have appeared. If a treatment fails (whether
traditional or alternative), the only way you will know is if
your son has X-Ray evidence of a TB infection. You have to be
willing to take that risk.
Anonymous and Concerned
I am an Rn, although I haven't worked for 15 years. Unless I
am mistaken, a positive tb skin test only means that a person
has been exposed to tb. ie the body has had enough exposure to
mount a response to the antigen(the tb) but not necessarily
enough exposure to result in the disease. Once exposed, the
body reacts by developing antibodies. The presence of the
antibodies result in positive tb test--the antibodies attack
the killed mycobacterium given in a tb test, resulting in the
redness and swelling at the site of the injection.
Unless your son has a positive chest xray, or sputum test--
(which I'm not sure they still do) or is sympotomatic in some
way--chronic coughing? I can't understand why anyone would
recommend treatment. There is nothing to treat unless he has
the disease. Tons of people have positive tb tests, and no
are you sure your child got a TB test in Mexico? or maybe got a
vaccination? - these ARE routinely given in mexico though I
don't know what age.
if he or she just got the test right after birth - how would the
exposure have happened? in utero? - doesn't make sense to me
a test needs to be read by a medical person 48 to 72 hours after
it is given - do you know if this was done?
on the other hand, if a vaccination was given, he or she will
always test positive and will need the chest xray instead for
all the activities in this country that require a test.
Can anyone recommend a drop-in clinic for the Mantoux (using a
needle under the skin) TB test in Berkeley ? I need to get
tested but getting to my doc's office in the city is a hassle.
I'm not sure if ''Mantoux'' is different from the regular TB skin tests that
one normally receives, but the Berkeley Free Clinic does them in the
evenings from about 6-8pm on a drop-in basis. You just call at 5:45pm
and ask if they can take you. Call ahead to double check because it's
been awhile since I've known anyone who's been there.
University Health Service (Tang) did this for me for free a couple
of years ago. I tried to pay, but since I worked on campus they
considered it a covered expense even though we didn't have them
as our primary care doctors.
The Berkeley Free Clinic does same-eve TB tests for
anyone; you need to call them [510-548-4811] at 5:45pm
[no earlier] on any weeknight [except Thursday] that you'd
like to be seen and the Medical Appt. Taker will sign you up
for an appointment after 7:00 pm. The appt. lasts about 20
minutes and you need to come back 2-3 nights later for the
results and the verification slip. It's free, it's great, and
although your test will be done by a [very well-trained] medic,
not a professional, it's a totally acceptable and excellent
service. Oh, did I mention FREE? Although donations are
If you have questions you can e-mail me directly.
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
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
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
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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