skin test why sputum culture?

[JNet 1]

VJers. Why do they do a sputum culture and not a skin test at St. Lukes in Manila? My fiance had pneumonia 3 yrs. ago and has a doctor's certificate confirming that she is healthy. She has some minimal scarring on her xray so they want a sputum test done. Am I crazy for thinking they should do a skin test 1st to see if there is a sign of TB in her system and then do the culture test? Also, if you have the skin test done is it 100% accurate. I would like her to take that next week so we can be prepared for the sputum results. Any responses are appreciated, but I truly hope that someone reading this has some experience or knowledge about this topic. Thanks, Joe

[Dogwood_Poet 16]

They do not do the skin test because there is a TB vaccine that can cause a false positive, so I guess that answers your second question as well, the test is not 100% accurate.

Do not worry, my wife had to take the sputum test because of her x-ray as well and they let her know at the end of the testing she should have nothing to worry about, but they still had to wait for the culture results to be sure. Just make sure you have plenty of time before your interview for the results to come in.

[sofia2009 1]

VJers. Why do they do a sputum culture and not a skin test at St. Lukes in Manila? My fiance had pneumonia 3 yrs. ago and has a doctor's certificate confirming that she is healthy. She has some minimal scarring on her xray so they want a sputum test done. Am I crazy for thinking they should do a skin test 1st to see if there is a sign of TB in her system and then do the culture test? Also, if you have the skin test done is it 100% accurate. I would like her to take that next week so we can be prepared for the sputum results. Any responses are appreciated, but I truly hope that someone reading this has some experience or knowledge about this topic. Thanks, Joe

Because most of the Filipino's has BCG vaccine(TB vaccine)..If they will do the TB skin test, it will always come up positive..so TB skin test is not 100% accurate...I have BCG vaccine, and I am always positive on TB skin test so that's why I have to fill up some form every year here at work if I have sign and symptoms of TB..

[JNet 1]

Great info, thanks you guys!

[vsmtghdy 2]

TB SKIN TEST - positive results means you had "exposure" with PTB... which is either through the previous BCG vaccine which most Pinoys have and since most also have prior exposure when they were young and not necessarily have the PTB infection (Primary Complex or PTB). This will be a 100% accurate for Countries who don't have a big incidence/ statistics with PTB, but not the Philippines. But not all of those who had prior BCG vaccines will be "POSITIVE" with the TB SKIN TEST.

Sputum AFB - will determine if patient have the Mycobacterium, but a negative test does not always mean that the patient don't have PTB. Since there is also a Classification of PTB that is: "SPUTUM AFB NEGATIVE PTB" and they also need to be treated. It is still the Doctor's discretion (Pulmonologist) to treat or not the patient with anti-Koch's medicines, especially if the CXR is highly suspicious for PTB and/or if patients are symptomatic.

Sputum AFB Culture and Sensitivity - they will have the organism grow in a culture media. Since Mycobacterium Tb is slow-growing, this usually takes a minimum of 3-4 weeks to grow them. When they have the organism, they will be subjected to a sensitivity test to see which drugs this organisms are still sensitive so the doctors will know which drugs to give to the patient.

Hope this info helps.

[Skeeter211 2]

Helen....or anyone...do you know what the embassy does for children (K-2) for the medical for a TB test. The guidelines say they don't do an x-ray for children under 15 years. Do they do the skin test? That takes 48-72 hours to read, doesn't it? We only have planned for her to be in Manila for the two day medical and that might extend it if she has to wait for the results of a skin test.

My step-daughter is going for her medical next week for the K-2 and she just caught a cold/cough. She went to the doctor at home and got some antibiotics to hopefully clear it up, but if she still has a cough, I am concerned they may make her take a sputum test. Any ideas? I know my wife got a cold also just before her medical and we were worried then too and it went okay, but I have heard of others that have had a cough that were given the sputum test. What's the difference?

Thanks for any help.

Scott

[vsmtghdy 2]

Scott,

They don't usually do CXR and/or serological (blood) test on applicants 15 years and younger, but it will depend on the Panel Physician's evaluation if the applicant will need one especially if there's a strong suspicion of a possible infection (like Pulmonary problems whether it is Primary Complex or Pneumonia).

Primary Complex (TB in the young) and BronchoPneumonia may present with the same signs and symptoms and they can only distinguish it by doing further work-ups like CXR or sputum exams. PTB will stain positive for the sputum AFB -> because they are acid fast bacilli and with Bacterial Pneumonias, they usually do sputum gram stain (sputum G/S) and not AFB, but with both conditions, they can do the Sputum Culture and Sensitivity (Sputum C/S).

On CXR - finding perihilar lymphadenopathies will most likely point to a Primary Complex and perihilar infiltrates will most likely be due to Pneumonias.

It would be better to prepare the medical certification from the Doctor that will indicate that your daughter-in-law was treated for ______ (diagnosis) and the medications given and if they did CXR, maybe also bring the CXR plates just in case SLEC will asks for it. Present only these things (Medical Certificate and CXR plates) if they asks. . .

Hope this info helps.

[Skeeter211 2]

Helen, Thank you for the reply. I don't think she has a full blown pneumonia, but rather just a chest cold that has caused some phlegm. My concern was that they might hear her cough and right away order the sputum test, but I admit my knowledge in this process is limited. I guess we can only hope for the best.

The bad news is my mother-in-law just went to pick up Krrystal's passport so they can leave for Manila tomorrow and were advised that due to "technical difficulties" passports that were due today will be delayed. YIKES!!!! We are panicked now and hoping it will not be too long of a delay. Her medical is actually not scheduled till next week, so I guess we will be changing the flights and hotels to have her go when she was actually scheduled to do the medical and pass on the early attempt. Oh well, nothing we can do.

Thank you again for your prompt and thorough reply.

Scott

[warwick8 0]

Allot at least 3 days for her medical in case they needed to do the skin test. If the skin test turns out to be positive, they will do an xray and u have to go the following day to get the xray result. One of the girls I was with when I had my medical had to have her flight back to the province changed because her son's skin test turned out positive so they had to do the xray.

[chipsahoy 3]

I was diagnosed PTB last Jan. 2006. The same month we applied for K-1 visa. I underwent medication for 6months (Jan-July) to avoid delays with our application. I finished medication a day before my medical appointment and asked my doctor too for mediacal certificate that states I completed all the medicines prescribed and clear with PTB. Still and all, St. Lukes had me underwent another series of x-rays and 3-day sputum (3 out of 3 were negative). God's goodness, I passed medical without delays. So it's really recommended to get an early medical.

One month after I got here, I repeated my xray and sputum plus the tuberculin skin test. The result of xrays were cleared and sputum were all negative again but skin test was positive. The doctor said that once a person have positive TB, s/he will always have a positive skin test. If your fiance took all the medicines prescribed to her and completed 6-months (usually) medication, methinks, there is nothing to worry about. Good luck!

Julie

[Dave+Rose 0]

TB SKIN TEST - positive results means you had "exposure" with PTB... which is either through the previous BCG vaccine which most Pinoys have and since most also have prior exposure when they were young and not necessarily have the PTB infection (Primary Complex or PTB). This will be a 100% accurate for Countries who don't have a big incidence/ statistics with PTB, but not the Philippines. But not all of those who had prior BCG vaccines will be "POSITIVE" with the TB SKIN TEST.

Sputum AFB - will determine if patient have the Mycobacterium, but a negative test does not always mean that the patient don't have PTB. Since there is also a Classification of PTB that is: "SPUTUM AFB NEGATIVE PTB" and they also need to be treated. It is still the Doctor's discretion (Pulmonologist) to treat or not the patient with anti-Koch's medicines, especially if the CXR is highly suspicious for PTB and/or if patients are symptomatic.

Sputum AFB Culture and Sensitivity - they will have the organism grow in a culture media. Since Mycobacterium Tb is slow-growing, this usually takes a minimum of 3-4 weeks to grow them. When they have the organism, they will be subjected to a sensitivity test to see which drugs this organisms are still sensitive so the doctors will know which drugs to give to the patient.

Hope this info helps.

I just had my medical exam feb. 19-20 and it was successful. Next week my 10 year old daughter will have her medical for K2 visa. She was supposed to have her medical on Mar 4-5 which is the medical appointment given to us by USEM however the nice doctor (Room 5) told me if I can do it, I should reschedule her for a week earlier so we will have ample time before the interview. 10-14 yrs old are given skin test and it takes 2-3 days for the reading. If the result is negative, the K2 proceeds for the immunization on the 3rd day, if positive, then sputum test is done. The doctor further told me that its safe to allot 1 week for the K2 medical...just to be safe. Hope it helps...I took the doctor's advise than being sorry later.