Nurse with Positive(+) Skin Test for TB but with NEGATIVE(-) Chest x-ray result

Diseases & Conditions Rheumatoid Arthritis
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confused   sad  

I NEED HELP!!! I am a registered nurse from the philippines & have migrated to the USA (Feb 2006). I underwent a complete medical examination (Jan 19, 2006) required by the US embassy in Manila (St. Luke's Extension Clinic) & have passed all the medical test, including the chest x-ray, the reason why I was approved for the migration. I never had any problem with my yearly medical in my country (we have a mandatory annual physical examination for 9 straight years) but no skin test examination. I was informed by a friend who works as a nurse here that it is mandatory for all nurses to undergo skin test for TB, so before applying for the nurse position, I tried to have it & be tested. IT TURNS OUT TO BE POSITIVE (+). I was seen by a doctor from Houston Texas & have examined my chest x-ray taken last Jan 2006 to see if it is possible for me to have another chest x-ray or even further medical evaluation & management. After evaluating my x-ray, he says I should not go on with the skin test exam in the future for it will turn all positive result. He told me I don't need a new chest x-ray. I also ask him if I need to undergo a prophylaxis (drug treatment) & he says "NO"! He just gave me a certification that I have a positive (+) skin test & negative (-) chest x-ray & currently asymptomatic. He told me if I will be ask to undergo another chest x-ray, then I should submit myself to the request.

MY QUESTION (S):

1. CAN I WORK HERE AS A NURSE now that I have a positive skin test for TB but with negative chest x-ray result ?

2. DO I NEED TO TAKE THE PROPHYLAXIS(DRUG TREATMENT)?

3. ARE HOSPITALS HERE ACCEPTING NURSE APPLICANT WHO TESTED POSITIVE(+) WITH THE SKIN TEST EXAM?

 
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Hi Ellen,

I'm not a nurse, so I'm not familiar with nursing employment policies regarding positive TB tests.  I do know that positive tb tests from immigrants to the U.S. is very very common.  If you have a negative chest x-ray, then you're just fine.  I would think that would suffice for any type of employment.  I used to work with a number of immigrants from South America, many of which tested positive for tb.  They also had negative x-rays and were allowed to keep their present jobs. 

I also think, in your case, that prophylactic tx may do more harm than good.  For what it's worth, I agree with the doctor you saw in Texas--you do not need tb tx.

I'm sure others who are more knowedgeable will be along soon.

Elcamino

Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan

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Hi,
Try not to worry too much. Protocol is: if you have a + TB skin test....another one is given 4 weeks later (called a 2 step PPD). If it shows +, then CXRAY is performed to R/O TB latent or inactive TB. A treatment of antibiotics may be given for a while if doctor sees fit or if there is an indescrepency. If you were exposed to TB or have had it in the past, it'll show on the skin test.
But if all protocols are gone through & doctors gave you clearance everything should be just fine.
This is very comon.
Take care.
erin

Active/Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Prednisone 20mg; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 60mg; Reglan; Antivert 25mg tid; LidoDerm; MiraLax & too many others.

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:-)  

Hi, Thanks for an early reply. Now I am relieved with this stress, can rest my mind of thinking negative & go on with pursuing my career here as a nurse. When my results turned positive w/ the TB test, it made me feel useless as a nurse. I thought I will not be able to practice my profession here. THANK YOU VERY MUCH FOR ENLIGHTENING ME. GOD BLESS YOU ALL.......