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Just wanted to clear a concept about TB
If children exposed: do ppd
If neg: still treat with INH plus vit b6
Repeat ppd in 3 mnths: if neg: stop tx
if pos: continue tx for 6
Confusion is here: if immunocom/child: continue tx even if ppd is neg??
Can someone please clarify
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MOST IMPORTANT THING YOU NEED TO KNOW ABOUT PPD AND TB IS:
1. It is mainly used as a screening tool for latent TB and not for diagnosing Active Infections....
THINGS TO NOTE ON PPD TEST IN CHILDREN:
1. Reporting of PPD test is often inaccurate.
2. False Negative tests are seen in children especially in malnoursihed child, in those with a severe disease and around 10-20% among isolated pulmonary disease....
3. Also, PPD test will be suppressed in children with viral infections (eg, measles, influenza, varicella, and mumps), also after live virus immunization, and during corticosteroid or other immunosuppressive drug therapies....
4. For all the reasons above, a negative test DOES NOT ALWAYS EXCLUDE DISEASE....
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According to CDC guidelines even in immunocompromised or less than 5 years you stop treatment if PPD negative at second testing(8-12 weeks postexposure).
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correct
in immunodeficient child where anergy is expected, continuation of treatment even after 3 month negative PPD must be based on the exposure - how serious was the exposure to TB? very close contact etc...if thats the case, yes continue full 9 months.
But if it was a trivial exposure, no further treatment once 3 month ppd is negative.
Same guidelines for AIDS patients.
