My 2 year old recently had a TB skin test which was positive. He has a BCG vaccine. He had a chest x ray which came back clear but I've been told I need to put him on a 9 month course of antibiotics regardless of the chest x ray result. I'm very hesitant to put him on such a long course of antibiotics when I'm not 100% certain he really needs them. Is there another way to determine if he really has latent TB? I would like him to have a 2nd TB skin test in a few weeks to see if its positive again. I've heard that scratching or putting pressure on the site of the skin test can sometimes cause a false positive result and my son was prodding at his arm soon after the test was administered. Does anyone have any suggestions of what I should do? I've read on line that there is a blood test for TB but there's some uncertainty about using it for kids. Does anyone know anything about this?
What you describe is a rather complex situation. The previous administration of BCG can cause false positivity of a tuberculin skin test. In addition, a second test could be increasingly positive because of the initial tuberculin test. There have been reliable studies of blood testing (interferon gamma release assays) in children that may allow medical personnel to distinguish between a legitimately positive skin test and a false positive.
The bottom line is that in the situation you describe, accurate interpretation of the skin test may be beyond the scope of many physicians. I suggest that you and your son’s doctor request a 2nd opinion from a physician, perhaps in the local Public Health Department, who specializes in the diagnosis, treatment and prophylactic treatment of suspected TB. Given that a 9 month period of drug therapy/prevention is being considered, you would be wise to seek an expert opinion.
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