Positive Skin Test After Contact With Active TB Patient. Have Asthma. Done Chest X-ray. Does It Indicate Active TB?

Posted on Fri, 7 Sep 2012

Question: I came into contact with someone who was diagnosed with active TB. My skin test was positive. I also did a chest Xray. Does the chest Xray indicate Active Tuberculosis? I have Asthma. I do not have a fever, night sweats, weight loss. No cough but I am noticing a bit more phelgm perhaps due to my Asthma. Please let me know if there any abnormalities in the Xray.

Answered by Dr. Gyanshankar Mishra (8 hours later)

Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:
1. You seem to be a diagnosed case of asthma currently on inhaled medications.
2. You recently had a brief contact with a case of active TB. Your skin test is positive.
3. Your symptoms seem to be suggestive of a secondary respiratory infection.
4. Your xray does not indicate any feature of active tuberculosis disease at present.
5. I suggest , you take a 2 week course of broad spectrum antibiotic like (Amoxicillin clavulinic acid) under supervision of your doctor. If the symptoms do not subside then further investigations in the form of sputum afb, HRCT thorax and/ or bronchoscopy may be required.
6. Thus you need to get yourself evaluated from a pulmonologist.
7. Also do get your total serum IgE levels tested and get yourself vaccinated for influenza and pneumococcus.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (25 minutes later)

Thank you for your reply. Therefore the x XXXXXXX does NOT indicate any active TB? That is quite a relief.

Just so there is no misunderstanding, I am experiencing NO symptoms except slight increase in phlegm production. I meant to write that I am NOT experiencing any of the typical tuberculosis symptoms such as fever, night sweats, fatigue etc.

Does this change any of your advice?

I had frequent contact with the person diagnosed with TB. He was hospitalized but is recovering now. I last had contact with him while he was untreated in May. Since you there is no case of active TB, there is no risk to my family or friends?

I have an appointment this Saturday with a pulmonologist.

Answered by Dr. Gyanshankar Mishra (2 hours later)

Hi,
Thanks for the follow up query.
After going through your follow up query, I would like to comment the following:

1. You do not seem to be suffering from ACTIVE PULMONARY TB DISEASE at present.
2. The skin test is positive which means that you have latent TB infection and not disease. latent TB infection is very common and need not be treated.
3. About one-third of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease.
People infected with TB bacteria have a lifetime risk of falling ill with TB of 10%. However persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill.
4. Your symptoms are most probably a result of secondary respiratory infection.
5. There is NO risk to any of your contacts.
6. Its good that you have an appointment with a Pulmonologist.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar