Tb Exposure

[Dakhar]

Folks, I was exposed to TB (copious amounts). What I am asking, is what is the first course of action?

I am really really really scared. I called Bumungrad, and they say the do a combined test of PCR (blood sample) and skin test after 2 weeks post exposure.

It is not a money issue, it is a scared issue. I know of people that have died on the treatment, and I am so very scared right now. I have a history of being very intolerant of meds too. If I get diagnosed ASAP, I mean within weaks of exposure how much better are my chances? Are PCR studies accurate?

If I test positive, but yet I am still asymptomatic at the time of testing, do I assume I am a latent carrier, and not worry. If I am a latent carrier, does this work in my benifit for the recent exposure? I assume I could have latent TB because I lived in Asia for 4 years.... I may have come across it some time or another. Anyone know who I should seek help from, hospitals doctors etc?

I am an American with no history of immunization for tb. I am not known for a strong immune system, in fact I have weak lungs a long history of bronchitis etc. I get sick just by standing at the welcome mat at a hospital.

My wife is pregnant, my son has been immunized. What procautions should I take.

i am sooooo scared

[Sheryl]

First of all, calm down. The odds are you are not infected, and that if you are, it is only a latent infection.

Even health professionals working with TB patients seldom get it. Many of them never even sero-convert, that is to say they don't even develop a latent form. Altho some unlucky people get TB without any known exposure, in most cases it takes repeated close exposure over a long period of time to get infected.

PCR test is going to cost you big bucks and I think is over kill.What you should do, AT ONCE, is get a skin test (PPD) to establish your baseline status. If it is negative, then repeat it at intervals as advised by doctor, if you then later test positive they will know that it means you have newly acquired the infection although it still doesn't mean you have the disease. They will then do a Chest Xray to determine if you have active TB or latent. If only latent, treatment is somopler (fewer drugs).

If on the other hand you are already PPD positive, this means you have acquired the infection at some time in the past, almost certainly latent, in which case most people would say just annual Chest films as long as asymptomatic.

[Dakhar]

If I do a skin test within the next few days, will this skew the results of a PCR that according to Bumun can only perform the test 2 weeks post exposure?

[Sheryl]

No, it shouldn't. Get the skin test. If it is negative, rather than an expensive PCR, just have a repeat skin test oa month or more later by which time, if you do have the TB bacilli, the reaction should have turned positive .

Getting a PCR as opposed to this approach will not alter the treatment in the least. In addition, I do not see how without a prior baseline (blood or skin test) they can be sure that a PCR result would mean new infection.

I assume since it is all you mentioned that it is only TB exposure we are discussing and not also HIV.

If possibly HIV then a PCR may be worth doing (for the HIV, not the TB).

[Dakhar]

No to the HIV

Sheryl, not to question your knowledge at all.... but I think this is why they (Bumun) said to have the skin test and the PCR 2 weeks post exposure.

If the skin test is negative and the PCR test is positive, then that would indicate a new infection?

If the skin test is negative and the PCR is negative, then that would mean NO TB is within my body?

If the skin test is positive, and the PCR is positive, then there is no indication if this a latency, new infection TB positive etc? It will just tell us that I have TB?

Compare that with Xrays and I gues that will tell us if this is latent, or new, because as of right now and I would imagine 2 weeks now I would be asymptomatic?

From my readings it sounds like TB is hard to find out until things get out of hand, or you just have a routine screening and it shows a positive response. From that point treatment is decided.

I think u are correct in stateing that getting a skin test done now, and then one latter would indicate a new infection.

The reason I would want a PCR is so I could put it behind me. Meaning that If it is negative, then I can move on????

If the PCR is negative, do I get a BCG?

Sorry SHeryl, I do have a lot of questions about this. I am a basket case of worries.

PS, am I correct in the assumption that I should be asymptomatic at the moment? Right now, I have reduced apetite, no energy, depression, night sweats, can't sleep, no fever..... basically I think this is do to psychological worries more than anything.... am I correct in that assumption?

Thank you much for responding

[gunnyd]

If you have a positive Mantoux PPD test (intradermal injection resulting in a bump) it does not mean that you have TB. Have you had a PPD done before? and if so was it negative? If you have had a previous negative PPD and then have a positive PPD then you should be evaluated more closely.

Bumrungrad is an excellent hospital, if it was me I would trust their doctors. And the doctor you should be seeing should be a specialist in infectious disease control. As for getting a BCG vaccination it really isn't necessary, unless you are a long term resident in Thailand or any other country in SEA.

Me and my wife have never heard of a person with suspected TB getting a PCR test. F.Y.I. I am a Registered Nurse and my wife is an M.D. in the USA. But a PCR test is used in the diagnosis of TB rarely, usually in a suspected drug resistant case, but not as a front line test. A positive test only means that you were exposed to TB not that you have it or carry it. I myself converted i.e. went from having negative PPDs to testing positive, I assume this occured because of my work in healthcare. That just means that I get Chest X-rays done on a 5 year basis unless I were to become symptomatic.

I totally understand your worries with your wife being pregnant. When my wife was last time, if I had a runny nose or cough I wore a mask around her.

But from what you describe I wouldn't get overly stressed. Until you are finished being tested, and make sure it is a doctor that specializes in Infectious Disease, wash you hands diligently, wear a mask if you feel the need, and don't kiss your wife. Most likely you don't have anything wrong with you and if your PPD test is positive and you haven't had one before, you could have been exposed at anytime during your life. That is why PPDs are just a diagnostic tool, not a definitive test. Try to relax it is not the end of the world, and if worse comes to worse TB is very treatable.

Good Luck

Darrell "gunnyd"

[gunnyd]

Also all of the patients that I have had that were suspected of having TB always had a sputum culture done not a blood test.

Cheers

GunnyD

[Dakhar]

Thank you Sheryl and GunnyD for your help.

I am a stress case, and I have been one since I was a teenager. I even deveiloped ulcers in my mouth and I do not know if I should attribute this to stress or illness? But I did take half a xanax and it has helped a lot with the anxiety.

I had a xray done, and a skin test done tonight. The film was negative, the skin test, we have to wait and see.

I had a skin test done ahout 14 years ago, and if my memory is correct, it was negative.

GunnyD there really is no sputom to test. The exposure occured on the 8th, and I have developed some feelings of a cold comming on, sore throat, a little post nasal drip, fatigue, loss of apetite etc...

But to be honest, even those symptoms have depreciated some.... I atribute that to the xanax. I have been known to stress out to the point that I think my immune system gets out of whack and I get sick....

Which is probably not good for a person that was exposed to TB.

So any how, now it is a sit and wait thing, to see what the skin test says. Then I plan on doing another one in the future or a PCR.

If I do have TB, do they do a culture synsitivity test if requested. Because really my body does not like medicine, and the shot gun approach may just end me!?

Thank you guys....

Thank you very much.

[Mossfinn]

Hi Dak,

Folks, I was exposed to TB (copious amounts).

Could you elaborate? How were you exposed to copious amounts, particularly as you are a bag of nerves regarding this, it sounds like you wouldn't have gone gung-ho into such a situation knowingly and voluntarily.

I am not sure how you are describing, 'copious amounts', were you in close contact for considerable time, did an infected person, who is not, 'in treatment', cough or sneeze directly at you, or in close proximity?

As discussed above, it is quite difficult to catch, even with a compromised immune system.

GunnyD there really is no sputom to test.

If I do have TB, do they do a culture synsitivity test if requested.

Because there is no sputum now, meaning a dry cough, it doesn't always mean their wont be, keep a pot close at hand at all times, it really is a good way of diagnosing for sure, growing a culture over a max of approx 49 days.

I am not sure what you mean by, 'culture sensitivity', but there isn't much that can give you the heeby-jeebies regarding this kind of culture, you just cough up a sample into a specimen pot, unless you mean something entirely different.

The above posters have more knowledge than me and it is good advice, but I guess there is little point in asking you to calm down until you have a positive outcome, which can mean either way.

Remember if you are diagnosed, it can be treated, generally quite successfully in most cases.

Good Luck

Moss

[Dakhar]

Suffice it to say, copious amounts, and there is no way in haties I would have gone gun-ho into this if I would have known better.

By culture sensitivity, I mean, sometimes physicians have the bacteria cultured, & then the run tests on the culture to find out exactly which medications would be best to kill off the bacteria. I would be interested in this type of approach because it would help to elliminate some of the 4 (?) drugs used in the treatment of TB. In other words, if they find out that 2 of the 4 are useless but the other 2 are great... then theoretically all I should have to do is take 2 drugs.

But I am newbie to all of this, so as GunnyD said... I am going to have to trust the doctors. The doctor I dealt with today, I could tell he thought I was just a basket case worried about nothing.

If I were in his shoes, I may feel the same. But from my position.... I am worried.

7 hrs after the skin test and thus far no apparent reaction at the point of application. I don't know if this is just cause to celebrate or what.

It is a base line though....

Folks, I can't even begin to express how grateful I am for your advice.

Dak

[Dakhar]

I could not find the eddit button:

Regarding the type of exposure level. One example.... the person had a peice of hard candy and their mouth, did not like it and stuck it in my mouth. I was not expecting that to happen, and in fact I did not find that to be a nice thing to do.

So essentially I know I was exposed to saliva. This person was then diagnosed with active TB maybe 10 hrs after that... and laughed about it.

"All I have to do is take some pills for 6 months no big deal."

I am furious! I sometimes work at hospitals, and even then I do so in fear, and this is before this type of exposure.

This really concerns me:

"Routes of GI infection include the following: (1) spread by means of the ingestion of infected sputum, in patients with active pulmonary TB and especially in patients with pulmonary cavitation and positive sputum smears"

.emedicine.com/RADIO/topic885.htm

I can't say I swallowed someone's sputum, but definitely got exposed to this person's saliva!

I also read that oftent times folks with GI type TB test negative on skin tests. (if I read that correctly)

I did ask for a QuantiFeron Gold test. The doctor (not at Bumngrad) stated that he was aware of that test, but they do not use it. So I did the skin test instead.

Because the QF Gold is done off of drawn blood, I would assume that a GI issue would show up?

Thanks again for your shoulders.

[seonai]

I'm going to post something in the original TB thread now to add to this... hard to know where to post but my thoughts are to go with the original Dhakar

[Mossfinn]

fatigue, loss of apetite etc..

O.K these are typical symptoms of TB symptoms, but hang on, if I was stressed whilst awaiting an outcome, I would have these too.

But to be honest, even those symptoms have depreciated some....

There you go, some good news.

By culture sensitivity, I mean, sometimes physicians have the bacteria cultured, & then the run tests on the culture to find out exactly which medications would be best to kill off the bacteria. I would be interested in this type of approach because it would help to elliminate some of the 4 (?) drugs used in the treatment of TB. In other words, if they find out that 2 of the 4 are useless but the other 2 are great... then theoretically all I should have to do is take 2 drugs.

I have never heard of this, so thank you for that.

Suffice it to say, copious amounts,

did not like it and stuck it in my mouth.

So essentially I know I was exposed to saliva.

Dak, just to try and alleviate your concerns a certain amount, this is my opinion is not copious amounts, a concern, definitely, but not copious amounts, just wait on the tests.

One example....

Were there more?

QuantiFeron Gold test

Dam_n, I was in the TB clinic today and forgot to ask about this, search on the forum for more info, unless you already know enough about it already, I have my doubts about its effectiveness in everyday, one test tells all, efficacy.

Good Luck

Moss

[seonai]

My cultures tested sensitive to Rifampicin last March so they kept me on it until last week. It has caused massive orange rashes on both egs but seems to have done the trick... I hope

I have to add though Dak that I was also on Ethambutol, Izoniazid, Ciprofloxicin and Azithromycin for a year and a half. So don't know that your cultures will mean you have to take less drugs. they are desperate to stop this disease and so will give any amount of drugs to get rid of it

[Dakhar]

Seonai,

The culture concept was strictly an idea. Seonai, I physically have a hard time with antibiotics. I was on cipro for about 5 days and it litterally hurt my bones ached and my gums burned.

Seonai, I have read some of your posts, and I am so scared of my future.

I have a lot of nausea, but again this could be attributed to being a nervous wreck.

12 hrs no into the skin test, and no visualized response.

Again, I know it is just a base-line and 80% accurate But is some ways it gives me hope.

Right now if have a touch of sore throat, slight nasal congestion, naseua & fatigue. I woke up sweating...

But as of yet no fever that I am aware of.

All of which could be attributed to other things. IE, my son has had a bad cold for 2 weeks, I may of been carrying what he had, got stressed out, immune system decreased and poof, I get a cold.

It is not that I am in denial, it is just that I have no proof of Tb or not, and it sounds as though I have to wait about 12 weeks before anything could be said for sure.

Although the PCR os suppossed to be accurate at 2 weeks post exposure.

I think I may go for a PCR at 2 weeks, if that is negative, then go for QuantiFerron at 12 weeks.

If that is negative..... cry like a baby for gratitude.

[Dakhar]

How soon do symptoms appear?

Evidence of infection (a positive skin test) may occur from two to twelve weeks after exposure to TB. The risk of TB disease is highest during the six months after infection, and remains high for two years; however, many years can elapse between initial infection and TB disease.

.health.state.nd.us/Disease/Documents/faqs/Tuberculosis.pdf

So to me, I think that this means all of these symptoms I have had are either:

1) Psychologically bassed

2) Infection of another sort

3) Co-infection TB plus something more rapid but more

[Sheryl]

For sure, the symptoms you are having are not from TB. It is either pure nerves or maybe you are coming down with a cold, or some combination of both.

Please try to calm down. The hard candy/saliva bit does not present anywhere near the risk you apparently think it did. In fact saliva rarely if ever contains TB bacilli. Presumably the person you were exposed to had pulmonary TB (the most common type) and to have contacted it from him/her you would need to have inhaled his/her sputum (phlegm) from deep in the chest.

PCR, skin test and the "Gold" test all test the same thing, which is presence of antibodies indicating that you have, at some point in your life, been exposed to the TB bacilli. None of them tell that you have active TB. The PCR is a very expensive, time-consuming test done in cases of very early exposure where they use special technicques to multiply the antigen (bacteria or virus) that may be present at that point in only trace quantities to a level where it will react with antibodies. There is virtually no reason to do this for TB exposure.

Since all of these tests just conform or rule out exposure at some point, they don't mean anything unless you know you were negative at some specific point in time. Hence the recommendation to do a skin test now. From the sounds of it, it will be negative. That just means no past exposure. Need to wait a month and repeat it, at which point odds are surely greater than 100 to 1 it will still be negative, at which point the sensible thing to do would be relax and forget it but if you insist, repeat again at 3 months and then forget it.

BTW unless the person is severely malnourished or immunocompromised, false negatives with the skin test are not likely. When the skin test is inaccurate it is usually in the direction of a false positive (especially common in people with multiple allergies). Again, immunocompromised and malnourished are an exception to that but I am assuming you are neither.

Even if you convert to positive, you will most probably have only latent form not active TB. For which there are 2 approaches: do nothing but have periodic chest xrays, or take a course of medication to suppress it, which in case of latent TB can be a single drug. But you are really way ahead of yourself in worrying about this.

Dakar, some degree of concern is appropriate but you're over the top on this to put it mildly. Do you think you may have a gnerealized anxiety disorder? People who do will often latch on to specific things to be anxious about, but the anxiety was there to begin with.

Anxiety will do more harm to your health than the various things you are focused on worrying about. I think you would do well to consider therapy (see pinned notice on this forum).

[Dakhar]

Dakar, some degree of concern is appropriate but you're over the top on this to put it mildly. Do you think you may have a gnerealized anxiety disorder? People who do will often latch on to specific things to be anxious about, but the anxiety was there to begin with.

Anxiety will do more harm to your health than the various things you are focused on worrying about. I think you would do well to consider therapy (see pinned notice on this forum).

Anxiety, Yes I would say I have that. Was it there before this? Yes, I would say it was there before this.

But lets be clear, TB is something to be concerned about. I may be over the top, from your educated view, but from my uneducated view, TB is worth worrying about.

Ironically, I work in the medical field. Nothing special really, but I diagnose, test etc certain medical conditions. Sometimes when I sit down with patients they start to cry... like I just told them they have cancer, when the reality is... their issue is something everyone will have one day, due to age. So I think to myself, "Good grief, get a grip..."

As you are probably thinking too about me.... but remember, TB apparently is your niche, it aint mine, and to be honest TB kills. So yea, I am nervous.

I understand how PCR studies work, and if it is diffenitive, then I want one. According to Bumun, they charge 3K for one. For me, that is like 1% of my monthy earnings.... if I want to spend my money that way, for a blanket of security that can be obtained in 2 weeks rather than 12.... I will do it. But again, only if PCR studies based on blood samples provide definitive answers. I have only found information about PCR studies and TB based on sutum samples thus far, and Bumun uses blood.

Honestly, I think most folks would do the same, in my position?

But I do appreciate your help, advice and concern & in no way am I telling you, you don't know what you are talking about. I am sure you have seen patients before that tell you something off the wall, and you just bite down smile and move on. Everyone has their cruch, and mine happens to be technology. (PCR)

I thank you for your further explanation regarding the accuracy of TB skin studies. I also wonder why this person that I was exposed to has active TB. This person is not a smoker, drug user, neg. HIV, etc. (to the best of my knwoledge) I can't put my finger on it, but in reality, I don't care to maintain contact. Not after treating this as if it were some kind of laughing matter. The doctor did not order a skin study, he just ordered exrays, AFB study & sputum culture. As you know that culture will take like 6 weeks. I think the doctor made a diagnoses based on exrays, case history, and the AFB results.

PS: Now 21 hrs and skin test still no reaction. The doctor wants it read at 72 hours. & thanks again.

[seonai]

Take care Dakhar, I would like to know the outcome of your situation. For me it was not a 'straight line' as I said before. I thought I'd be in hospital a month and then home, take the meds and then fine. But in my case it didn't work like that. I manage very well now though, there are ways of managing disability.

Try, if you can, not to stress too much until you have something positive to work with though. Stress really does make it worse - if you DO have anything the stress further weakens your immune system so try to think of beautiful things and wait until you get some results back

Keep us posted please,

[Dakhar]

Take care Dakhar, I would like to know the outcome of your situation. For me it was not a 'straight line' as I said before. I thought I'd be in hospital a month and then home, take the meds and then fine. But in my case it didn't work like that. I manage very well now though, there are ways of managing disability.

Try, if you can, not to stress too much until you have something positive to work with though. Stress really does make it worse - if you DO have anything the stress further weakens your immune system so try to think of beautiful things and wait until you get some results back

Keep us posted please,

Senio,

Yep that is what I am concerned about. TB does not provide a road map, it is not a straight line. You got it, and apparently for no logical reason.

I do have disability insurance coverage in the state, health insurance here in Thailand, and for the worse case, I have a good life insurance policy. So if everything goes deep south, I know that my family will be secure.

But as you say, sit back relax and wait on results.

Thus far 32 hours into the base line skin test and thus far no reaction.

Thanks again to everyone.

[gunnyd]

Dakhar,

32 hours and no reaction is a good sign. Usually Mantoux PPDs react inside of 24 hours in a person without a compromised immune system, i.e. HIV/AIDS, post organ transplant. PPDs are read 48-72 hours post test and repeated two weeks later.

It really sounds like you are in a dark place. Trust your doctor, rest, and try to keep your head on straight. I know how your feeling, I myself have the same bad habit of expecting the worst. You are light years away of even thinking about your life insurance. Someone needs to crack you upside the head and get out of the funk you're in.

With no reaction to the PPD yet IMHO you have a .00000000001% chance of having TB. Even it is positive it just means you have been exposed, and even if you were to have TB, even the drug resistant types, it is very treatable.

I am sure I am not alone in saying that my thoughts are with you.

Now quit assuming the worse.

GunnyD

[Dakhar]

It is now 47 hrs and there is a very very slight bump or hill, by no means a blister. You can not even see it, you have to touch the area, and I do mean it is slight, and no there is no denial here, I am trying to be discriptive. The slight hill is all within the original injection zone. The nurse gave the injection and then out lined it with a pen. The slight bump is within the shot. When I mean slight, I am talking less than a musquito bight type bump.

I guess that is normal. I mean, the body should try to fight it at some point?

My son had a BCG shot without a skin test prior to the shot, when he was around 2 years old. The poor kid.... at the injection site, a huge blister formed, that remained for about 4-5 months. We even had it drained 2 times. He is fine now. Little scar, we used some scar reducing med, seems to work.

My point in mentioning this is that I would imagine if I were positive I would get a blister of some sort, and I do not have that.

GunnyD,

This skin test is just a base line, it will let me know that I did not have TB prior to this exposure. I will have to wait 2 weeks for the PCR, in order to find out if TB is in my body or not from this exposure.

Yes, I am in a funk, and yes I have a sore throat.... bummer. But I take comfort in the fact that technically speaking the sore throat should not have anything to do with tb (?) and that so far, I know I do not have Tb prior to this encounter.

Thanks for the post.

Dak

[Sheryl]

The skin test is read in terms of how many mm from the injection site any redness or swelling extends. It can be red and bit swollen and still be negative if the reaction is of limited size.

From what you describe your test is clearly negative. Now you need to wait and then either repeat skin test or have blood test as you prefer.

The advantage of the PCR is not that it is more definitive (altho its reliability is good) but that it can detect TB in immuncompromised people who may fail to react to skin test etc. It can also be dione much earlier after exposure, which would be its advantaghe in your case.

[Dakhar]

The skin test is read in terms of how many mm from the injection site any redness or swelling extends. It can be red and bit swollen and still be negative if the reaction is of limited size.

From what you describe your test is clearly negative. Now you need to wait and then either repeat skin test or have blood test as you prefer.

The advantage of the PCR is not that it is more definitive (altho its reliability is good) but that it can detect TB in immuncompromised people who may fail to react to skin test etc. It can also be dione much earlier after exposure, which would be its advantaghe in your case.

Well as expected the base line skin test was determined negative.

Sheryl if you say that the PCR is reliable at 2 weeks, then I think I will do it. It is only money, and I woul rather spend it than worry. I am happeir about the current results, but I have a nagging fear down inside that will only be put to bed by the PCR results. It has now been essentially a week post exposure. So I will probably get the test done on the 22nd, exactly 2 weeks.

Sheryl, do you feel it would be best to wait 3-4 weeks post ex. for a PCR? Or is 2 weeks reliable enough?

Thanks again folks,

Dak

[Sheryl]

It is matter of how soon after a hypothetical respiratory exposure there would be trace amounts of TB bacilli in your blood, and I don't think anyone actually knows that, because, in contrast to HIV, there is rarely a single known exposure event followed by testing. If they told you 2 weeks, I'd suggest you give it 3 to be sure, if your nerves can hold up.

[Dakhar]

Sheryl

I think you are correct when you mention HIV. I can not find anything in regards to solid onset times for TB. I can not fnd anyting regarding contraction odds etc in regards to TB.

HIV, there is all kinds of statistics, tables, onsets, symptom break down charts etc.

TB just seems to be a hit and miss.... seems to me, it is a very under researched disease for what it is.

3 weeks..... OK then, I have to look over my schedule, but I think that will be fine. 3 weeks really means wait another 2, because I am already in to this 1 week. Not so bad of a wait?

I think I should do as you said, because if I test at 2, I think I will have a nagging suspicion?

Dak

[seonai]

I think you are right Dak, it took 2 years for me to be properly diagnosed in Thailand and even when I came to UK for treatment everyone didn't really know/still don't know what they are dealing with regards TB. With HIV it's fairly straight forward, TB forget it. In hospital nurses were coming into my side room asking me 'Should I wear a mask' and stuff like that!!! It's MAD and very upsetting

[Dakhar]

I am here to post an up-date. I went to Bumun and saw a pulmanary doc.

Sadly, the guy was not very informed. He did not want to do a PCR for TB, he never heard of the QuantiFeron Gold, and he felt that I should wait for 12 weeks before I do any more testing. (I had a TB skin test performed and an x-ray perfromed 3 days post exposure for base line purposes)

At first he wanted me to get a skin test and an x-ray for diagnostic purposes, and I explained to him that I had a base line skin test and x-ray done 3 days post exposure, and that from what I have read, skin tests should not be considered vallid until at least 10-12 weeks.

He advised against having another skin test due to the fact that they would be 17 days appart. He stated that would cause a false positive. (I came home only to read/discover that was not accuarate advice, in fact contrary to what is supposed to be done)

He made some calls to the lab, found out that they will soon offer the Quanti Feron Gold (Offered in 4 weeks, estimated price 3-5K) and the lab rx. the test to be performed 12 weeks post exposure.... (I must give the guy some credit, at least he was willing to make the phone calls, and he did do some "google work" right in front of me. Docs in the US I doubt would ever Google in front of thier patient.... they would rather make up a big load of Krap and smile....

Post exposure test time estimation based purely on speculation, no real scientific data. The lab stated that they can perform a PCR test based on a blood sample, & a skin test should be performed again at the 10-12 weeks post exposure to confirm PCR results. (PCR TB 3,900 BHT)

So essentially it sounds as though the PCR does not hold a lot of diagnostic weight.... but I did it any how. The doctor stated that most PCR tests are performed during active TB, based on sputom samples, and those tests are performed to measure treatment efficacy and to determine the type of TB. Which I believe to be accurate, but I have seen research based on PCR being a test used for early detection, much like the HIV PCR concept.

The doctor asked, "Why are you so concerned, TB is not like HIV?" Well that was conforting....

Any ways folks..... I will keep you all posted as things develop

Edited February 28, 2008 by Dakhar

[gunnyd]

Sounds like your doctor has the bedside manner of one from the US.

I hate to say it but you're going to have to be patient and wait.

I case you havent been here this is a good reference on TB: American Lung Association TB page

Stay sane, GunnyD

[Dakhar]

Another quick up date. I got the PCR results and they are negative, again basedon a blood sample. From what I have read, blood sample accuracy seems to be around 40%, so a coin toss would have been more reliable. But that is just my uneducated opinion.

Now I must wait another 8 weeks for a skin test, and possibly a QuantiFeron Gold test. The QuantiFeron is crazy expensive though. I may just use the old reliable skin test. Any thoughts on that?

Thanks again

Dak