Understand ppd reading

Hi,

as i wrote in my earlier email:
Recently, my daughter had a ppd skin test for her new school which came out positive. She gave BCG in her 1 and a half months of old. From 1 year of age, she is living in usa. Her last 2 ppd in usa was negative.

She is very healthy, no problem. -ve Chest x-ray.

Do she need any medication? Medication may cause some liver damage and it has other side effects too. I am afraid.

One more Question is: her recent ppd reading is big. it is 20mm or 15mm. Today is 8th day, still she has red mark on her ppd test place. What does it mean? Is that any kind of other reaction? Like - her ppd wasn't perfect? i have no idea.

Would it be helpful to have another skin test before beginning any kind of medicine?

Any information will help this worried mother a lot.

Thanks

Samantha

[National Jewish]

This is an unusual story.  The Purified Protein Derivative (PPD) skin test for tuberculosis may be positive or negative after getting the Bacille Calmette-Guerin (BCG) vaccine.  When the BCG vaccine causes the PPD to be positive, the typical pattern is for the initial PPD to be positive.  The PPD may become negative over time.  It is puzzling that your daughter had two negative PPDs after getting the BCG vaccine.  Then she had a strongly positive PPD with a 15 to 20 millimeter bump.

That raises the possibility that your daughter has had a tuberculosis mycobacteria (TB) or nontuberculous mycobacteria infection.  However it doesn