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Question : Today I tested positive on my TB skin test. I feel fine. I was told my chest x-ray was negative. What is the next step I should take?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 10, 2014
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Tuberculosis (TB) is a bacterial infection that most often involves the lungs. But it can also affect other parts of the body.

Most often, you catch TB by close exposure to someone else that is infected and is coughing. Bacteria coughed into the air can enter your lungs when you inhale.

Over the next few weeks, the bacteria can produce an active infection in your lungs. This can lead to fevers, weight loss, sweating (particularly at night), coughing and other symptoms.

More often, fortunately, the bacteria live quietly in your lung for many years without causing an active infection that damages your lung tissue. Your immune system keeps them in check. But there is always the threat that the bacteria may one day "wake up" and start causing lung damage and symptoms of infection.

Regarding your positive TB skin test, the next steps depend upon the answer to these questions:

  • Have you had TB skin tests in the past that have always been negative? Is this the first one that has turned positive?
  • Have you had close exposure to someone with newly-diagnosed, active TB?
  • Is your chest x-ray completely normal without any scarring or other suggestion of a prior active TB infection?
  • Have you recently emigrated from a country that has a high rate of TB?
  • Is your immune system impaired by a medical condition, such as HIV, or drug therapy?

If you’ve answered “yes” to any of these questions, your doctor will likely recommend a course of antibiotics to prevent active infection.

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