Provider Fact Sheet

Provider Fact Sheet Evaluation of exposed contacts: Exposure to Tuberculosis  TB skin test by the Mantoux method (5 Individuals exposed to an adolescent or adult with TU PPD injected intradermally and read pulmonary or laryngeal tuberculosis are at high at 48 – 72 hours by a health care risk for infection with M. tuberculosis and professional) unless previously positive progression to tuberculosis disease (TB). Because progression to TB is most likely in the first two  History and physical exam evaluating for years after infection, this group should be TB (symptoms of TB include cough in evaluated and treated aggressively. 70% of adults, fever (60%), weight loss, fatigue, chills etc. Hemoptysis is The following information regarding the source uncommon.) case is helpful:  Chest radiograph  The intimacy and duration of their contact. o if the patient had a prior positive TST  Information regarding the level of contagion of the source case (patients o if the patient has a positive with long-standing symptoms, smear TST positive sputum and cavities on o if the patient has a negative radiograph are more likely to be TST and: contagious) is HIV infected  Sensitivity of the source case TB isolate. < 5 years of age is immunocompromised has symptoms of active TB

Classification of Individuals Exposed to Active TB

* Young infants may not make a positive skin test – talk to a TB expert if the exposed is a young infant

Diagnosis TST Symptoms of TB Radiograph Treatment Class 1 TB < 5 mm None Normal if done Consider “window exposure INH” for 8-10 weeks – then repeat TST* Class 2 or latent > 5 mm None Normal Treat with 9 months of TB infection INH (LTBI) Class 4 old-scarred > 5 mm None (cultures Stable over three 4 mo INH/RIF TB negative if done) months 9 mo INH * Class 5 TB suspect May be Present in > 80% of Abnormal in Report to TB control; positive or adults with TB pulmonary TB four TB drugs after negative cultures

From Pediatric Tuberculosis: An Online Presentation by Ann Loeffler, MD. Produced by the Francis J. Curry National Tuberculosis Center.