Exposed to infections TB AFTER treatment for latent TB
April 19, 2021 4:10 AM   Subscribe

My mom got a letter from public health saying she's been exposed to infectious TB. She was treated for latent TB in the 1970s when she immigrated to Canada. She has a mark on her lungs still visible now that is somehow the result of that. What happens now? Oh, and she has an auto-immune disease but is not on biologics.

So she has an appointment for a skin test, but my understanding is that once you've had latent TB, you will ALWAYS test positive in a skin test. So I guess they'll do an x-ray? but that just tells you if it's active now, right? Will she have to do x-rays all the time, especially given that she takes medication for rheumatoid arthritis (but not any biologics)? Or will they just treat her as though she's infected, just in case? And if so, will she have to go off arthritis meds while they do that?

The family doctor's office called back to book the skin test, but didn't really give much more info. I did confirm that the doctor was aware she was treated for latent TB before. I don't know if we'll get more info at the skin test just because I expect a nurse will just do it, not the doctor.
posted by anonymous to Health & Fitness (4 answers total)
She'll need to call the doctors office and remind them of her history , that she had latebt tb and had been treated for it previously. Usually they just check chest xrays, if required, absence of other symptoms. I think I was tested once a year in the US via xray , but it was usually due to some outside requirement like work.There is a blood test that can be done instead of a skin test.

I, a person who has lots of skin reactions, ended up being tested via ppd, treated and then years later given a blood test that came back negative for ever having been exposed in the first place (and this was in like 2008? ) so they may want to test her no matter what. Though from my understanding what happened to me is incredibly rare.

This is definately reach out to your doctor and ask a bunch of questions.
posted by AlexiaSky at 4:23 AM on April 19, 2021

Skin test will not work for her, as it's an antibody test and she is positive for antibodies by virtue of previous exposure.

Although I'm not a doctor I have worked around TB and TB patients, and been exposed. I did the research when I was exposed, and opted not to get any treatment, but I did not have a previous case of active TB (which I think you mom did, if she has a spot on her lung). A lot is known about TB, a conversation with her doc and some research should tell you the likelihood of actual active TB for your mom, and then you decide whether you want to pre-emptively treat based on those chances.
posted by OmieWise at 4:33 AM on April 19, 2021

I had the BCG vaccine years ago (which should make me react to a prick test, I think) but I came up clear when I had a blood test a year or two ago. Seems like she would need a blood test.
posted by How much is that froggie in the window at 7:27 AM on April 19, 2021

Was there a phone number for public health included in the letter? Most public health departments will have some kind of nurse or someone who coordinates TB for the county. This person will be more knowledgeable than many providers about the appropriate testing, follow up, etc given your mom's history.

I suggest trying to speak directly to that person, ask if treatment is being recommended, ask what follow up testing is needed, and ask them to coordinate with/call your mom's provider.
posted by latkes at 11:48 AM on April 20, 2021 [1 favorite]

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