Tuberculin Reaction Size and Treatment of Latent Mycobacterium tuberculosis Infection | |
| RISK GROUP | TUBERCULIN REACTION SIZE, mm |
|---|---|
| HIV-infected persons | ≥5 |
| Recent contacts of a pt with TB | ≥5a |
| Organ transplant recipients | ≥5 |
| Persons with fibrotic lesions consistent with old TB on chest radiography | ≥5 |
| Persons who are immunosuppressed-e.g., due to the use of glucocorticoids or tumor necrosis factor α inhibitors | ≥5 |
| Persons with high-risk medical conditionsb | ≥5 |
| Recent immigrants (≤5 years) from high-prevalence countries | ≥10 |
| Injection drug users | ≥10 |
| Mycobacteriology laboratory personnel; residents and employees of high-risk congregate settingsc | ≥10 |
| Children <5 years of age; children and adolescents exposed to adults in high-risk categories | ≥10 |
| Low-risk personsd | ≥15 |
a Tuberculin-negative contacts, especially children, should receive prophylaxis for 2-3 months after contact ends and should then undergo repeat tuberculin skin testing (TST). Those whose results remain negative should discontinue prophylaxis. HIV-infected contacts should receive a full course of treatment regardless of TST results.
b These conditions include silicosis and end-stage renal disease managed by hemodialysis.
c These settings include correctional facilities, nursing homes, homeless shelters, and hospitals and other health care facilities.
d Except for employment purposes where longitudinal TST screening is anticipated, TST is not indicated for these low-risk persons. A decision to treat should be based on individual risk/benefit considerations.
Source: Adapted from Centers for Disease Control and Prevention: TB elimination-treatment options for latent tuberculosis infection (2011). Available at http://www.cdc.gov/tb/publications/factsheets/testing/skintestresults.pdf.