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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does It Indicate Tuberculosis If PPD Test Shows 8mm Positive Result And Sputum AFB Smear Test Shows No Acid Fast Bacilli?

I have pleural effusion (L) 2° to Parapneumonic process as diagnosed by an internal medicine doctor, and I had medications of Azithromycin, 3 days and Sultamicillin for 3 weeks. After almost two months, the results of the x-ray doesn't change, it still has the same patterns or the semi-blurred parts is still the same. This week, I had PPD test and Sputum AFB Smear test. The PPD test shows an 8mm positive result while the Sputum AFB Smear test result is -- NO Acid Fast Bacilli Seen. Does this mean I have Tuberculosis?
Mon, 27 Jan 2014
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Pulmonologist,  's  Response
Hi,
Please see if the effusion can be tapped for diagnostic tests. If ues then under USG guidance they can be done.Serum quantiferon gold could help. If that is not possible, then based on non response to antibiotics, empirical anti tb treatment can be started after a ct scan thorax and provided other diseases have been ruled out. 8 mm ppd is normally a negative test. You can seek the opinion of a Chest Physician (Pulmonologist) for detailed clinical evaluation to rule out other causes.
Regards
Dr. Mishra
MBBS MD DNB
Consultant Pulmonologist
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Does It Indicate Tuberculosis If PPD Test Shows 8mm Positive Result And Sputum AFB Smear Test Shows No Acid Fast Bacilli?

Hi, Please see if the effusion can be tapped for diagnostic tests. If ues then under USG guidance they can be done.Serum quantiferon gold could help. If that is not possible, then based on non response to antibiotics, empirical anti tb treatment can be started after a ct scan thorax and provided other diseases have been ruled out. 8 mm ppd is normally a negative test. You can seek the opinion of a Chest Physician (Pulmonologist) for detailed clinical evaluation to rule out other causes. Regards Dr. Mishra MBBS MD DNB Consultant Pulmonologist