Guidelines for Referrals to the San Francisco TB Clinic
To refer patients to the San Francisco TB Clinic, please complete the interagency TB47 referral form OR provide complete information of your work up and reason for referral on a SFGH consult form or physician letterhead. Those without a referral will not be seen.
We do not accept referrals for:
- Employment and general TB screening
- Asymptomatic patients with prior history of completing LTBI treatment
- Asymptomatic patients with positive TST or IGRA (QFT, T-spot), normal chest x-ray, and no special medical condition
Referred patients must be residents of the City and County of San Francisco and have one or more of the following criteria for referral:
- Patients with suspected or confirmed active TB disease. This includes:
- Patients with symptoms consistent with active TB disease
- Patients with abnormal chest x-ray consistent with active TB
- These patients MUST be reported directly to the program. DO NOT send the patient directly to the clinic as a walk-in. More referral/reporting details at Suspected/Confirmed Active Case Reporting.
- A tuberculin skin test reading ≥ 5 millimeters or positive IGRA (QFT or T-spot) with abnormal or normal cxr and any of the following risk factors or special medical conditions which increase risk of progression to active disease:
- Children under 5 years of age (0-4 years old)
- Asymptomatic persons with radiographic evidence of old, healed TB
- Contact to active TB cases
- New TB test conversion to positive (previously documented negative TB test)
- HIV
- On immunosuppressive drugs (steroids, cancer chemotherapy, post-transplantation cyclosporine, TNF alpha antagonist or other biologic agent)
- Complicated LTBI treatment:
- Intolerant of > 1 LTBI regimen and risk factor for progression
- Viral hepatitis AND – Drug induced hepatitis: LFTs > 3x wnL with symptoms, >5x wnl without symptoms
- Methadone treatment with risk factor for progression or special medical condition
- LTBI with immunosuppression and requires DOT
- Patients without a medical home requiring program or shelter clearance