Managing Positive Reactions
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