Evaluation of Positive Skin Test

• Perform Chest x-ray
  • If normal, then have latent tuberculosis infection and should start anti-TB medications
    (may hold therapy if recent BCG or documented multiple BCGs, or low endemic rate of TB in country of origin)
  • If CXR abnormal:
    • Should be evaluated by the use of early morning gastric aspirates in an attempt to recover the organism for antimicrobial susceptibility testing.
    • May need further testing to identify extrapulmonary disease based on age and exam
    • Start anti-TB medications