inf q12 - irp

[ArchivalUser]

A 40-year-old male high school teacher is evaluated because of a reactive tuberculin skin test of 12 mm of induration done as part of a pre-employment physical examination. The patient has always been in good health and takes no medications. At the end of the last school term, he relocated to a different state and will begin teaching at a new school. He has an occasional dry cough but is otherwise asymptomatic and has no known contact with persons with tuberculosis. His last annual tuberculin skin test induced 10 mm of induration. Physical examination is normal.

Which of the following is the most appropriate management at this time?

A Begin isoniazid, 300 mg/d
B Collect sputum for acid-fast stain and culture
C Obtain a chest radiograph
D No intervention is necessary

[ArchivalUser]

ccc

[ArchivalUser]

ddd

[ArchivalUser]

C..

[ArchivalUser]

CC

[ArchivalUser]

ans ddddd

This low-risk, asymptomatic person has a nondiagnostic tuberculin skin test reaction for latent or active tuberculosis. Three cut-points have been defined for a positive tuberculin reaction: >5 mm, >10 mm, and >15 mm of induration. The cut-off threshold of >15 mm is used for all low-risk persons, such as the person described in this clinical scenario. Since his tuberculin skin test is not diagnostic for either active or latent tuberculosis, neither additional diagnostic studies nor therapy is indicated at this time.