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Tuesday, November 25, 2014
Chest X-rays after positive PPD
After prophylactic INH treatment for a positive PPD, am I supposed to still get annual chest x-rays?
No. Depending on which state you live and work in, your state law may require that previously PPD positive health care workers (regardless of prophylactic INH treatment) undergo a medical evaluation including chest X-ray upon hire by a new employer. Thereafter, some form of routine medical evaluation, such as a symptom screening, is frequently required of health care workers. A chest X-ray should be obtained if medically indicated, such as by persistent cough, chest pain, or unexplained weight loss. But the risk of reactivation tuberculosis is low, and the CDC does not recommend annual chest X-rays for PPD positive people. You can call your local health department for guidance about what the requirements of your state's laws.
Lisa A Haglund, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati