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Managing Positive Reactions

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Symptomatic Patients

If the patient is symptomatic, obtain a chest x-ray immediately.


Consult a TB medical expert to determine if urgent referral to TB Clinic or hospitalization is indicated; SF TB Clinic: (415) 206-8524


TB Test Positive Patients

If the skin test or blood test is positive, a chest x-ray and medical evaluation are indicated (evaluation may be done at the TB Clinic if referral criteria is met).


If the chest x-ray is not suggestive of TB, the patient may be a candidate for preventive therapy.  Preventive therapy is indicated for certain risk groups.


If the chest x-ray suggests active disease, the following steps should be adhered to:

  • Collect three sputum for AFB smear and culture, as soon as possible.
  • Report the case to SF TB Control within one (1) working day (required by California law) by telephone, (415) 206-8524.
  • Start treatment with an appropriate four-drug TB regimen as soon as possible. Do not wait for sputum results.
  • Place the patient in home isolation.
  • Hospital isolation is advised for individuals who are medically unstable, homeless or living in a congregate setting. SF TB
    Control follows the California state TB guidelines regarding release of active TB patients to high-risk housing, work,
    correctional settings and inpatient settings.



Guidelines for the Assessment fo Tuberculosis Patient Infectiousness and Placement in High and Low-Risk Settings

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