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You Can Do It!!

Latent Tuberculosis Infection

Devang Patel, MD and Neda Frayha, MD
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Tags infectious disease · pharmacology · public health

Latent TB is common in many parts of the world and amongst certain populations in North America. Diagnosis is made by  tuberculin skin test or by interferon gamma release assay testing.  Treatment gold-standard is nine month of isoniazid (INH).

 

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Tulja P. -

Patient who received at BCG vaccine as a child with no risk factors for TB, no previous history or exposure to TB and is healthy without any medical conditions. When interpreting the tuberculin skin test, do you still use the >15mm as the cut off for a positive PPD test?

Neda F., MD -

Yes, but in patients who've received the BCG vaccine, it's preferred to obtain a blood test like IGRA/quantiferon gold rather than perform a tuberculin skin test.

Sungjin K. -

After treatment with rifampin and isoniazid, how do we confirm if the treatment was effective for latent TB? Would we repeat the Quantiferon study? If so, how often? Would the quantiferon study also stay positive like the TST?

Neda F., MD -

There is no need to repeat the quantiferon test or other IGRA, which are likely to remain positive after treatment. The patient is presumed to have been treated effectively, and they should monitor themselves for any symptoms of LTBI in the future.

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You Can Do It!! Full episode audio for MD edition 195:21 min - 92 MB - M4AHippo Peds RAP September 2017 Written Summary 315 KB - PDF