Oldest is in nursing school and before the students meet patients they had routine blood tests. She came up positive on the TB. More tests verified that, so she’s starting on antibiotics Monday. She doesn’t know where she got exposed, maybe at work (she works at an international convention center) or on a flight.
Because I’m of a certain age I asked her if she was HIV positive. No, she takes Humira for her psoriasis, making her vulnerable. Considering how many ads I see for that stuff, it should be my default cause; it is now that the AIDS patients my age are dead from TB. She honestly once asked me why she knows gay guys older and younger than me but none my age. I gave her the stink-eye for being stupid.
She sent me a letter from the health department detailing the tests she passed and how she’s safe to work in or visit her dad in a nursing home.
What I was told when I got a TB test (because I was going to teach), a positive reaction merely means one has probably been exposed to TB: the TB bacilli are in the body, but they’re latent. Antibiotics do a good job of knocking out them out, though she may have to be on them for awhile. Since she’s not contagious and is getting treated, this is more one of those WHEW, THAT COULD’VE BEEN AWFUL! moment than an OMG occasion.
I’m so glad she’s going to be OK and can visit you!
It is going to be a little bit of a problem with employment. Tell her to start a folder with her lab results and radiology readings. She is going to have to prove that the TB is latent. Will likely crop up every time she starts a new job.
Yeah - my dad always came up positive on TB skin tests. We even know where/when he was most likely exposed: in high school he helped the family business of undertaking/funeral director by helping to pick up the deceased and preparing them for burial. Including pick-ups from TB sanitariums in the days before antibiotics were a thing.
Never, ever got actually sick from that. Never showed any signs of have TB other than the positive skin tests.
Also worked most of his life in the healthcare field and hospitals. Got a few more chest x-rays than average over the years but it did not stand in the way of his employment.
A cousin of mine had a weird result from a TB test, he ended up having aplastic anemia and went through a couple years of hell there before getting a bone marrow transplant.
I’m 99.999% sure it’s just Latent TB infection (LTBI), which is dormant, non-contagious, gives no symptoms, does not damage the person with it. It can be treated with 12 doses of INH and rifapentine, once a week x 12 weeks. But mostly this treatment is only recommended for people with compromised or potentially compromised immune systems, as in healthy adults in the US, chance of activation of this LTBI in the person is very, VERY low.
I deal with this stuff on a weekly basis. in over 17 years of seeing about 3 positive TB blood tests a week in my patients, only two patients in those 17 years actually had active TB disease. The rest were LTBI.
Oh, and the blood test has a LOT of false positive results too, so the chances she has LTBI, even with a positive blood test, are probably about 20% or less. I had to review all this stuff two months ago for an affidavit for a court case, so I’m fairly current.
People with weak immune systems are more likely to contract and/or develop tuberculosis. As a result, a lot of people with AIDS end up with tuberculosis. I don’t know what percentage of people with tuberculosis are HIV+ (or, more relevantly, what the percentage was during dropzone’s era), but it’s not an out-of-left-field question.
If the daughter is concerned enough about her nursing-home-confined father’s health that she immediately informed him (and showed her medical records) that she tested positive for TB, wouldn’t you think that being HIV+ would be a conversation she would have had? Also, amidst her likely concerns about her own health and her future employment (in the two-decades+ I worked in the medical field, we ALWAYS knew who the TB+ coworkers were, which was a never-ending source of frustration for them about their medical history being a source of public discussion), I would hope that a parent would have “Gee, I wonder if she has another significant disease too!” pretty far down on their list of questions/supportive statements, particularly when that assumption still (stupidly) carries a tremendous amount of stigma, way more than a positive TB test.