Doctors' Answers to "Frequently Asked Questions" - Tuberculosis

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Postivie Skin Test for TB [posted 11/19/98]
Question:  My boyfriend is a healthcare worker who has had a positive TB skin test. The hospital wants hin to take INH as a preventative measure. He also has sickle cell. What are the risks that this could cause a crisis or damage his body systems?

Answer: Not zero, but pretty small. He will need regular monitoring of liver functions however,

Prednisone and TB [posted 8/7/98]
Question: A patient whose TB skin test was positive (previous exposure, but no symptoms) was treated for 9 months by the cocktail of the three strong medications. Now he has to take Prednisone. Is there a risk in taking the Prednisone, and if so, how big a risk?

Answer: Assuming that the three drug treatment has killed all the tuberculosis left in "scar " tissue, the risk of TB would be nil. In general, we think that 6-9 months of 3 drug treatment would sterilize most patients, so the risk of the prednisone causing reoccurrence would be very low. However, I would watch carefully for symptoms and have a low tolerance to treat since there is not absolute assurance that all the TB has been killed.

Tuberculosis
Question: I just returned from a five day trip to India. An associate of mine, who lives in India, was recently diagnosed with Tuberculosis on one of her ovaries. She told me she is not in the contagious stage of the disease. I was in her presence for six hours on January 20th. What risks, if any, do I have and what should I do?

Answer: Tuberculosis is one infectious disease caused by Mycobacterium Tuberculosis. It is one of the oldest diseases known to man. TB can be spread in many ways; but is usually spread by aerosol drops from coughing or respiratory secretions. Tuberculosis may effect almost any of the organ systems. However, involvement of internal organs other than the respiratory system is not thought to be especially infectious. Exposure to an individual with organ involvement who does not have respiratory involvement is of little risk. Skin testing by your physician will confirm any exposure risk.

Transmission
Question: I would like to know if a person is infected with tuberculosis, will the disease spread to the people surrounding, especially baby? Should the person infected with the disease be isolated from others?

Answer: Tuberculosis is spread by aerosolized tuberculli spread in saliva or exhaled air. This disease is infectious;but, not markedly so. The exception is the patient withTB of the vocal cords-they are very infectious. People who live around a patient with TB should be tested and probably retested after the person is no longer infectious;however, we no longer isolate the infected person. That was done prior to effective antibiotics for treatment and before better understanding of the transmissibility of the disease. Markedly infected patients are recommended to wear a mask for the first week or so of treatment if children or people on chemo or other insults to their immune system are in very close contact.


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