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:
- Please report these patients directly by form. More details at Suspected/Confirmed Active Case Reporting
- TB symptoms and suspected of having active TB (regardless of TB test results)
- An abnormal chest x-ray consistent with old or active TB without prior evaluation or treatment (e.g. chest x-ray with upper lobe
fibrotic infiltrates) - 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:- Asymptomatic persons with radiographic evidence of old, healed TB
- Contact to active TB cases
- Converter
- 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