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Old 01-19-2011
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Listening Management of Latent TB

Let's say that a pt has a 16mm PPD testing. He gets a negative CXR. That means he is a candidate of 9mo of INH. Let's assume that he completes his INH course.

My question guys is: What do we do next? Do we do a repeat PPD? I have searched a long way for this answer but I haven't been able to answer.

You would be very kind if you could give me an evidence based answer.

Thanks in advance!
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Old 01-19-2011
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i think that we repeat ppd after finishing Tx with INH.
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Old 01-19-2011
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Quote:
Originally Posted by cool_atomic View Post
i think that we repeat ppd after finishing Tx with INH.
Do you know for sure?
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Old 01-19-2011
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well, with any disease, we Tx and then check again after the course is complete if the disease has receded and if we can stop Tx or continue it for sometime more. MTB is no exception to this and my answer is based on this fact.
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Old 01-19-2011
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Originally Posted by cool_atomic View Post
well, with any disease, we Tx and then check again after the course is complete if the disease has receded and if we can stop Tx or continue it for sometime more. MTB is no exception to this and my answer is based on this fact.
Well, the reason i asked is because, since the patient was exposed to TB he would be able to develop a skin reaction to TB no matter if he is treated or not. It will be useful if someone had a clear cut answer. Thanks coolatomic for the input
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Old 01-19-2011
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After treatment, shouldn't the PPD register a smaller induration, like <10 mm? This should confirm eradication I assume.
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Old 01-19-2011
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yeah, technically the size of ppd must decrease because the intensity of infection should have decreased due to INH Tx.
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Old 01-24-2011
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Once a positive ppd,always a positive ppd.....so post treatment,it is not recommended to repeat ppd....however the newer tests for latent tuberculosis like quantiferon TB gold test would become negative after treatment.
This is my understanding,as the CDC guidelines say that once u have a positive ppd,u never repeat it.However please reconfirm it.
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Infectious-Diseases, Internal-Medicine-, Pulmonology-

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