Active Tubersulosis

Dear Doctor,

In late September I had ran into a woman in Aruba (south/central america, who is originally from Columbia). She was at a bar and I was oblivious that she was a commercial working girl. We french kissed (saliva) for about a minute. I don;t think she cough or sneezed (I had been drinking). When she asked me to pay her, I walked away. However, the next day I had the chills and diarrhea (both went away the following day - the chills was a one time episode at night).

Now 6 weeks later, I have a productive cough which produces white think phlegm. I was sick the last few days but not anymore (no fever over 100 degrees). I had a negative PPD at 3.5 weeks post exposure (probably too early) and I will go in for a second PPD next week.

Because TB affects 1/3 of the world and is highly contagious (and its rampant in South America) I am incredibly scared I have contracted tuberculosis (or another respiratory disease).

I know only a test is conclusive and I must wait 10 weeks to take a ppd test which I can rely on. But I need some comfort because I am very scared.

Thank You

[National Jewish Health]

The acute illness, chills and diarrhea, are as you suggest, unrelated to your encounter.  And the encounter, as described by you, would be unlikely to allow for the transmission of tuberculosis (TB), even if your partner had active disease.

You are right – a negative PPD at 3.5 weeks post exposure is unreliable.  Also, TB is a rather indolent disease, very unlikely to a result in cough or any other symptoms, at 6 weeks.  In addition to the PPD and chest X-ray, there are other blood/serum tests for the diagnosis of TB.

I would be inclined to regard this as an acute respiratory infection, probably viral and unrelated to your exposure, and one that will resolve spontaneously.