Sunday, March 14, 2010

Can an infant currently under medication w/ anti-tb for 2 mos now, be accurately tested via skin test?

our baby's (1y/o) 1st pedia diagnosed him having PM by looking at his xray result alone and prescribed the anti-tb kit. after 2 months we consulted a pediatric pulmonary specialist,due to persistent coughing, who conducted a skin test w/c resulted negative and ordered us to discontinue his medication. His 1st pediatrician reasoned that it would give a false negative because our baby has already started his medication.we are greatly confused 2 different views, from a pediatrician and a pediatrician-pulmonary specialist.who do we believe? pls advice anyone!tnx
Can an infant currently under medication w/ anti-tb for 2 mos now, be accurately tested via skin test?
For my money, I'd go with the pediatric pulmonary specialist since it is his area of expertise. A TB skin test would be more likely to be false positive than false negative because you are testing for antibodies to TB. Either you have them or you don't. While a pediatrician is excellent for the day to day ailments and routine care, there are certainly gaps when it comes to the more complicated issues- which is why there are specialists. I'd stick with the pulmonary specialist, because he's seen a lot more of this than a pediatrician would have, and have more experience with it. Diagnosing TB in an infant takes more than a peek at one x-ray, and recognizing it when you see it takes practice. If it were my child, I'd go with the specialist.

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