What next?

[TWR]

PPD POS..   CXR NEGATIVE,  TB GOLD "INDETERMINENT"    NO HX OF TB OR KNOWN EXPOSURE, PHYSICAL WAS NORMAL, WHAT NEXT?  THIS PHYSICAL WAS FOR A NEW JOB IN HEALTHCARE.

[rev ronin]

I don't think I'm supposed to copy/paste from UpToDate, but for hew exposure in healthcare workers, treat if newly positive, or retest 8-10 weeks if negative. OR if you decline tx, monitor annually. It's a pretty complicated algorithm, and the more I read of it, the less clear, concrete guidance there is.

[ventana]

This is likely LTBI. 
 

needs treatment. 
 

there are wonderful new treatments that shorten treatment to 3m.  And are actually tolerable.  
 

in my state their is a TB clinic that the state funds and it is strongly encouraged (but not required) to refer to them.  
 

 

in this case get a Cxr to make sure no pulm TB.   Then talk about treatment.   Should be very close follow up to ensure full treatment (to decrease mdrtb).  Hence why nice to refer to TB clinic. 

[SedRate]

How big of an area of induration? Does the pt have a h/o BCG immunization? 

[TWR]

15 hours ago, ventana said:

This is likely LTBI. 
 

needs treatment. 
 

there are wonderful new treatments that shorten treatment to 3m.  And are actually tolerable.  
 

in my state their is a TH clinic that the state funds and it is strongly encouraged (but not required) to refer to them.  
 

 

in this case get a Cxr to make sure no pulm TB.   Then talk about treatment.   Should be very close follow up to ensure full treatment (to decrease mdrtb).  Hence why nice to refer to TB clinic. CXR was negative