Living with TB

[zestcured]

Recently I went for a PPD skin test because I've lost my old records for TB treatment.  Moving places and countries for so many years.  I can't believe the reaction on my skin, it was so itchy with a little burning and visible swelling of the injection site.  Induration is around 20cm but the swelling around it is double in diameter.  If I touch the induration and press a little on it, I feel a slight pain.  Do I have to take meds after this test? The induration area looks nasty. Will get AFB smear test results tomorrow and the chest xray as well.  And two-year old chest xray was also submitted for comparison with the latest one.

[Corvin]

Your welcome,
I wouldn't have anymore PPD tests, given your strong allergic reaction if they want to check antibody reaction again and it's available have a QuantiFERON-TB Gold test instead. It has the same purpose as a PPD test but it's done in the lab from a blood sample and is more accurate and you avoid the confusion and discomfort of having the PPD.

http://en.wikipedia.org/wiki/QuantiFERON

It sounds like you've had good treatment, just be nice to have earlier chest x-rays. Seems a little strange you would still have a 20mm induration, but being infected when you were a kid and having active disease and treatment I suppose it's not that unusual. Part of the reaction could be from repeated PPD tests and non TB Mycobacteria like M. avium. But yeah it sounds like you've done all you really can, and got a healthy lifestyle going on. I think Rifampicin is the main culprit in the worse "allergic" reactions, in the US they just usually do Isoniazid alone for nine months for Latent TB(aka, prophylaxis).

I hope the cortisone cream helps, I might have to try some of that in the future myself if my sarc lesions get worse over time, they're fairly mild so far. Take care

http://en.wikipedia.org/wiki/Latent_tuberculosis

[zestcured]

Thanks Corvin, will try a hyrocortisone cream now. Regarding my history, I had contracted it in my teens, roughly 20 years ago. What I rememberd with the meds contained rifampicin+isoniazid...totally forgot the name of the capsule...I cannot even locate the clinic where I went to.  I remember the night sweats, dry coughing, burning sensation in my back that I can feel through my front chest.  It was PTB stage 1,  went for the full treatment for 4 months and it was adjusted at a lower dose until the 6th, wherein I stopped thereafter.  However the symptoms were gone on the first month that I took the meds.  Gets me wondering whether I had an overdose at that time.  I hated taking those meds because it made me dizzy and I was vying for top honors in my class - tough time maintaining a full treatment while concentrating in my studies at that time.  The doctor actually recommended for me stop regular school for a year.  I balked at the idea so I didn't follow his suggestion, though I took the meds.  Anyway over the years I changed my habits.  I got into active sports, didn't get into an active nightlife, no bars, occassional alcohol like wine and beer and no hard drinks really, occassional smoking only, no diet restrictions for me and it has been like that until now.  I was sickly until my teens most probably because I wasn't really physically active.  

Back in 2001, a new doctor suggested a prophylaxis for 3 months which I did follow even without the symptoms.  Bad mistake. The effect of the meds was even worse. I broke into cold sweats, had tinnitus, palpitations and flushed skin, not to mention burning urine.  Still I finished the treatment for 3 months.  At that time the calcifications are just exactly how I remembered it during my teens, I even managed to count them, only a few on my upper left lung region and very pale and small in size.  When I had another xray back in 2009 it still does look the same and even now.  I only had to this PPD test due to the fact that even the clinic where I had my prophylaxis was gone and stupid me for not remembering the doctor,  and how unacceptable that even the hospital has no archive of my records.  I did two months of recovering that information with that hospital just to have a clue to no avail.  No database, no archive.  I could have kicked myself really.  Now what I could suggest is for people to scan their results even the xray and store them in their yahoo or gmail accounts so that they can take it anywhere with them if they go overseas.

All in all, I think it's just a healthy lifestyle that prevented a remission.  The doctors are right to begin with, it's just these unnecessary procedures that I have to go through all over again due to loss of records.

Again, thanks Corvin!  

[Corvin]

Great news. What is your TB history from what you remember ? (just curious, guess I'm just wondering if you had active TB or latent TB in the past and what your treatment was)

Yeah they probably don't publish or volunteer information about what to do with an itchy PPD site because their trying to avoid people putting something on it before it's been read, possibly giving a false negative. But once it's read then it should be okay to put hydrocortisone cream on it, and maybe even cover it with a gauze bandage, that's about all I can think of to try. I never had a positive PPD so I'm not personally familiar with it.

Hope that helps some, take care...

[zestcured]

Thanks. I got negative bacilli strain.  Stable chest xray result as compared with the one from two years ago. I passed the medical clearance.

But the nasty ppd injection site is just so unbearably itchy, I had to consciously stop myself from scratching the site.  Any available relief I can use on it?

[Corvin]

Hi,
No PPD is only one part of the puzzle, but you're definitely positive for past exposure of TB. What your current state of infection is will be determined by the sum of x-rays, stains, cultures, clinical presentation, medical records...

If they can't confirm by medical records your TB history they'll probably just start fresh and put you on medication for what ever state of infection they determine you have.

Take care