PPD test

[pandora9048]

Hi.  Thank you for taking my question.  On Monday 1/24/05 I got a PPD test.  I work in a hospital, although not directly with patients, and we are tested once a year.
     Monday night I noticed redness around the injection site.  I'm not sure when this first occurred.  I noticed it in the shower about 12 hours after test.
     I've never had a redness after having a PPD test before so I assumed it may be positive and became really nervous.  I've had three different nurses look at it and they all said it was negative because there was no induration, maybe a local reaction?  one LPN used the term "blushing"
    It is not really raised.  There's is no hard bump or anything.  It is a red spot about the size of a nickel on my arm at injection site.  It is still here monday, 1/28/05, which I think is kind of long for a local reaction to still be here.
    My questions are:
      1)  Could this possibly be a positive PPD test, with erythema but no induration?   Why is it still here??
      2)  I would like to have the test repeated.  How soon can I safely get one?  I have an appt. with my m.d. on 2/7/05 and I want another one done.  is it safe to get another one so quickly?  and will it have a boost effect (I think that's the right term)  because of the 2 tests being done so close together?  
      Also, assuming it is positive, what is my next step?  am I contagious and putting my family at risk by kissing my
children et cetera?
Please advise.  I'm really worried.  Thank you for your time.
Pan

[National Jewish]

1.  A “positive” PPD test is defined by the presence of induration.  Even 50 mm of erythema would not be considered a positive skin test.

2.  I would not repeat the skin test.  Although it is safe to do so, you could see a boosted reaction.  You will have another PPD in a year so I would wait until then.

3.  If you had a positive PPD, you would not be contagious unless you were symptomatic and had an abnormal chest x-ray.

[OrthoRN]

Usually with a positive mantoux test, induration or hardness will occur at the injection site.  Some people will have redness at the site...likely due to a mild allergic reaction with the solution of an inflamation (inflammation) due to having the solution injected in the skin.  You can have 2 tests done.  Often, this is refered to a 2-step mantoux test.  It really won't hurt anything.  As for exposure, lots of people will test positive in this test....it does not mean that they have active TB, it only means that you had an exposure to TB.  Given that you work in a hospital...this might be likely.  Only a chest x-ray can confirm active TB.  Most people's own immune system will look after the TB if you're healthy...the odds that you are putting your family at risk is very low....  I certainly appreciate your concerns.  If you have a second reading that YOU are not content with, I would request a chest x-ray...just to put your mind at rest....if anything....

[bactitech]

I tested PPD positive about six years ago, with a very large induration that was exquisitely painful. My arm swelled up besides having the induration. I know that induration is read differently in different populations. Here is a website that has information on interpretation of PPD's:

http://tinyurl.com/58to9

Because this was work related (I work in a microbiology laboratory), I had a chest xray, which was negative, and insisted on seeing an infectious disease doc. Since my xray was negative, she put me on six months of daily INH, along with B vitamins. I also had a couple of blood tests to check liver function.

I had had negatives for years, and, believe me, I knew this was going to be a positive about 24 hours into it. The reaction was totally different.