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Tuberculosis Skin Testing
What is tuberculosis?
Tuberculosis is a disease caused by a bacterium (germ) called Mycobacterium tuberculosis. It is spread from person to person through the air in tiny droplets when an infected person coughs. A healthy person who inhales the droplets may become infected. Tuberculosis can affect almost any part of the body. Most commonly, it causes lung disease with a chronic, hacking cough. The sputum which is coughed up sometimes contains blood. Fever and weight loss are other common symptoms.How common is tuberculosis?
One hundred years ago, tuberculosis was common and was a frequent cause of death. After the second World War, there was a dramatic decrease in the number of tuberculosis cases. However, during the last ten years tuberculosis has been on the rise.What happens when a person becomes infected?
Usually a person who is newly infected does not feel sick. Several weeks after infection, the skin test for tuberculosis becomes positive; this may be the only sign that infection has occurred. The bodies of most people who become infected are able to resist the germs and remain healthy. However, a few people will become sick; this may happen months or even years after infection.What is a TB skin test?
The TB skin test shows if a person has ever been exposed to or infected with tuberculosis germs. It does not tell whether or not a person is sick with tuberculosis.How is the test performed?
A small amount of testing material is injected into the skin of the forearm with a needle. The person receiving the test must return within 48 to 72 hours to have the test read. IF YOU DO NOT RETURN TO HAVE THE TEST READ, THE TEST HAS NO VALUE. If there is swelling at the spot where the test was given, this indicates exposure to tuberculosis germs at some time in the past. Sometimes, especially for older people, the test is repeated in ten days to two weeks. This method is called a "two-step test" and is done because, many years after infection, the body's ability to react to skin testing may weaken and need boosting.Who should have a TB skin test?
Persons who are at risk of exposure to TB should get tested. These people include:
- Family members of people with TB
- People known to have close contact with persons such as friends and coworkers who have tuberculosis
- Health care workers
- Public service workers
- The homeless and people living in crowded conditions such as homeless shelters and health care facilities
- People who have HIV infection
Who should not get a TB skin test?
If you have ever had a positive skin test, you should not get another test. Instead, you should have a chest X-ray if you need to be checked for TB.What if my skin test is positive?
Most people with positive skin tests do not have tuberculosis. However, it is strongly recommended that a chest X-ray be obtained to be sure that there is not disease in the lungs.Where can I get a chest X-ray?
If you have a positive TB skin test, you may be able to obtain a free chest X-ray at a local community clinic or hospital. Call your local public health department to see if there is free testing in your area.Can tuberculosis be treated?
Yes. However, it usually takes a combination of several drugs for successful treatment, and the drugs must be taken for many months. Recently, some cases of tuberculosis have been caused by "resistant" germs, which do not respond to the drugs that are typically used. Such cases are more difficult to treat. However, in almost all cases tuberculosis can be treated successfully if found early enough and treated long enough.What if I have a positive skin test and a normal chest X-ray?
Sometimes treatment is given to prevent the development of tuberculosis. This treatment is known as "prophylaxis" and is done by giving a drug called isoniazid (I-soe-NIE-a-zid, INH) every day for up to a year.Who should consider taking prophylaxis?
People with positive skin tests who:
- Are close contacts of persons with tuberculosis
- Have recently developed a positive skin test
- Will be treated for long periods with cortisone-type medicines
- Have chronic illnesses such as HIV and diabetes
- Are under age 35
Prophylaxis is not routinely recommended for the elderly, people who are heavy drinkers of alcohol and people with liver disease.
This information is not intended to replace the medical advice of your doctor or health care provider. Please contact your health care provider for advice about a specific medical condition.
HIV and AIDS Hepatitis Adult Immunization Influenza Pneumonia Sexually Transmitted Diseases Tuberculosis Skin Testing