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Medical exams and related issues All issues related to medical exams for 485 filing.

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  #1 (permalink)  
Old 09-21-2013, 12:16 AM
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Exclamation BCG and positive TB skin test

So here is my story. I had 2 BCG vaccines (first when I was a baby and second probably when I was 8). So after my second BCG I always had positive results (around 7mm). I told my doc about it but he said I still need to take PPD skin test for my immigration papers. I had PPD test and of course it came positive (6mm). I mean for American department of health 6mm is negative but for immigration papers it's considered to be positive. And because of that I had to have an xray, which came back negative. Today I received sealed envelope from my doc and copy of documents (just so I know what he wrote down in the medical form). And what do I see? He wrote I have latent tb and the treatment is recommended.
I know I don't have to get treatment, it's just recommended. But what bothers me is that LATENT TB in my papers! I had 6mm reaction because of BCG not because of latent tb, plus my xray is perfectly fine, so why would he even write latent tb in my papers?! I asked him about it and he said "I know you don't have it but I had to write it down because of positive ppd".
Did anybody have a situation like that? Should I talk to my doc again and fight for "no class a or b" instead of "latent tb"?
I didn't send my papers yet
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  #2 (permalink)  
Old 09-21-2013, 01:08 AM
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lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts lucid1 is infamous around these parts
Default Interpretation of PPD

The interpretation of PPD test is dependent on the risk factors that are present in the person being tested. In your case 6mm is non-significant if you don't have any of the following:
1) HIV infection
2) Recent contact with an active case of TB (within last 2 years)
3) Abnormal chest xray
4) History of Organ Transplant
5) On immunosuppressive medications.

Please see CDC guidelines for interpretation of PPD test at this link (see the table on this page): CDC | TB | Fact Sheets - Tuberculin Skin Testing for TB

So in your case (provided you don't have any conditions listed above), your cut off for a positive PPD is 10mm. This is because you are an immigrant from a high prevalence country (that is why you had BCG twice when you were a kid).

Talk to your doctor and share this document mentioned above.
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Old 09-21-2013, 07:55 AM
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My situation :

The same thing happened with my wife too in 2007. She had a positive PPD and we explained about the BCG , the doctor then pretended to understand and said that we could take the treatment if we wished.

Two years later we get a RFE saying that treatment was recommended by the doctor and we should prove that we have completed the treatment.

By then we had moved from Florida to Virginia. We then met with a Virginia doctor and explained the situation (the dr by the way was Indian) she completely understood, she made my wife take a chest X-ray - the X-ray showed negative for TB and she probably put in a good explanation...and we responded to the RFE...4 yrs now....
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Old 09-21-2013, 08:53 AM
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Thank you for reply!
that's exactly the reason i dont wanna have false diagnose in my papers. The doc said i don't have to get treatment, that it is just recommended but im pretty sure if there is latent tb diagnose in my papers, one day it will pop up and they will try to treat me from something i dont have.
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Old 09-21-2013, 08:56 AM
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lucid1, i def don't have HIV or anything you listed! I will def talk to doctor again
Thank you for the info
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Old 09-21-2013, 11:26 PM
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Don't worry. My PPD was over 10 mm. the Civil Surgeon recommended treatment for latent TB which I ignored. Got my GC without any issue.

However, if you want to be sure , go to a free TB center (the civil Surgeon will tell you) ; they will give you some medicines . Throw those in toilet but you have a record that you took the treatment. that's what a friend of mine did.
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Old 09-22-2013, 05:34 PM
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Originally Posted by krishmunn View Post
......they will give you some medicines . Throw those in toilet but you have a record that you took the treatment......
Would not recommend "throw the medicine in the toilet" approach.

There is a 10% lifetime risk of developing active TB disease for someone with latent TB. Once you take the treatment (which is usually INH for 6 months), you are done.

The choice is yours!
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Old 09-22-2013, 09:18 PM
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Originally Posted by lucid1 View Post
Would not recommend "throw the medicine in the toilet" approach.

There is a 10% lifetime risk of developing active TB disease for someone with latent TB. Once you take the treatment (which is usually INH for 6 months), you are done.

The choice is yours!
These medicines have a lot of side effect. 99% of Positive Mantoux are due to BCG.
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  #9 (permalink)  
Old 09-23-2013, 09:21 AM
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Dear Blue-eyed,

I have seen people with BCG vaccines have no reaction to the sikn test.

A GC is of no value if you end up getting a full blown xdr version of TB.

Get it checked out. Think of this as a blessing in disguise. You found something that would cause you a lot of pain and suffering if not addressed properly. You have been given a free pass - don't waste it.

Don't bury your head in the sand.

Go to your county's infectious diseases clinic and take care of it.
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Old 09-24-2013, 10:08 AM
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Quote:
Originally Posted by ncrtpMay2004 View Post
Dear Blue-eyed,

I have seen people with BCG vaccines have no reaction to the sikn test.

Don't bury your head in the sand.

Go to your county's infectious diseases clinic and take care of it.
True, some people don't have positive reaction even if they had BCG. My reaction is 6 mm, it means it's under 10mm in my country im considered to be negative. before coming to the US (2 years ago), i went through medical exam and i also had PPD (7mm) and x ray and i never had diagnose Latent tb.
I'm not burying my head in the sand, im a very healthy person who is ALWAYS taking good care of my health. And i can guarantee i dont have latent TB.

Now continuation of my story. I went to Department of Health (here in the US, the same place where i had PPD), i told them my doctor wrote down latent TB in my paper work and they were shocked! They said im under 10 mm and im not in the group of risk (meaning i dont have HIV, i dont have donor organs and so on), so for department of health im negative, PLUS my xray is clear, so i do NOT have latent TB and my reaction is 6mm most likely because of BCG (allergic reaction). They said no doctor should prescribe any preventive medicine in my case, because it will just simply harm me.
So i think my doctor JUST ASSUMED i have latent tb. They said he could put that diagnose ONLY if i additionally took blood test (which is showing if you have tb infection and BCG can't influence it).

So now, knowing all the info im going to my doc and im gonna tell him all of that and we will see what will happen. I will post here as soon as i talk to him
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