[mevertin]

I posted last week that my baby had a positive reaction to his Mantoux test. The pediatrician I talked to on Friday said that any reaction over 10mm (his was 14mm) needs to be treated regardless of the BCG vaccine. Our regular pediatrician called today while we were at swimming lessons and the message he left was that he felt it was a false positive reaction and there was no need to treat with antibiotics. He basically said "see you at his next check-up." I am 99% thrilled we don't have to deal withe antibiotics but there is 1% neurotic mom that wonders if there is something to worry about. Anyone else go through this with their little one? I figure you guys are the pros.
Thanks
Mary
mom to Bobby 11, Bridget 9, Angela 8, Eddie 3 (home from Guatemala in 2005) and Naldo 13 months (home since Feb.)

[mommytoEli]

well....my child just had a positive...the doctor said bc it was over 10mm it was too big to be a false positive. they did a chest xray and it was clear, but bc he had a negative test 1 year ago, dr said she was certain he had been exposed in the last year and we had to treat it. if i were you....(i'm a neurotic mom too) i'd ask how soon the skin test could be repeated and make sure you follow up on it.

[Mindybeth6]

Many pedi's are NOT well-versed in +TB tests and do not know the proper course of action when it comes to getting a + reaction. I can tell you that if it is over 10mm it is NOT a false + test. The BCG test does not cause skin test reactions that large. My DD"s was just over 10mm and we had to do the medications. We were sent directly to an Infectious Disease Specialist at Akron Children's Hospital and it is one of the leading children's hospitals in the US. They know their stuff. I would highly suggest you get a second opionion and please read this article. At the VERY least they should have done a chest X-ray ASAP to rule out possible infection. I would not like it at all the my pedi was blowing this off...that would be a serious red flag to me. It is a very serious thing and I would seek another DR's opinion quickly.
Hugs
FCC: Tuberculosis testing and BCG

[Mindybeth6]

I wanted to add that you actually should NOT have another skin test done if you have EVER tested + for TB. I don't know the EXACT reasons why but it should be, from here on out, ruled out by having a chest x-ray done. I think the skin test can be dangerous to repeat? Someone I know will chime in on that for me.

[hopefully4]

I test positive for TB and the first test was borderline positive and the second test was a huge itchy rash on my arm. If you have one positive test, I think your reactions to it get bigger each time. My chest xrays have always been clear.

Katie

[JustBarbara]

Yup - I test + for TB every time but have only had one chest x-ray and it was ruled out. My three sisters also had + TB test probably due to the bcg.

[starryeyes]

I've actually seen it cause problems in patients - it turns into a blister if repeated and the "blister" can pop and develop into an ulcer on the affected site.

[avoel]

Please get a second opinion from an Infectious Disease doctor (preferably a pediatric one) on this. A 14mm PPD IS positive, regardless of BCG status, and does need to be treated in any child under 4 years of age. A negative chest xray in children, while good, does not rule out the presence of disease, because TB is children is rarely pulmonary TB. Rather it is usually latent TB infection that, if untreated, can rear it's ugly head later in life in forms such as hard to treat bone or even brain infections. Way better safe than sorry.

[KathyNC]

The Pede is not up to date on the current guidelines. The Red Book was changed (in around 2002) to state that the preferred course of action was to treat that size induration as a positive.

I went through the positive reaction with Carlos right after they changed this and despite some back and forth as to whether or not it was a "real" exposure, the consensus was to treat it as if it was.

Kathy

[cjrogers]

Agree with MindyBeth! A chest ray is absolutely necessary and treatment with the antibiotic is almost always routine as it will save you from issues later (camps, schools, churches, daycares, etc). The positive PPD will follow you around.

We saw an infectious disease specialist after our ped found it (in fact she referred us to them) and they told us the pros and cons of treating.

I highly recommend that you get a referral to a specialist. Our son's was only 8 mm, by the way and they still chose to treat.

Good luck.

[mevertin]

Thank-you for all your input. I knew my "forum friends" would have the scoop(thanks also for the link to the article Mindybeth!). I put a call into our ped. this afternoon. Hopefully he will get back to me before the weekend, but if not I will be on the phone again first thing Monday morning.
Mary
mom to Bobby 11, Bridget 9, Angela 8, Eddie 3 (home from Guatemala in 2005) and Naldo 13 months (home since Feb.)