1 Like
Question summary:
A 27-year-old woman with T2DM recently immigrated from Haiti and is asymptomatic. She has a 12 mm PPD induration, a normal chest x-ray, and a history of childhood BCG vaccination.
Answer:
C) Begin isoniazid therapy
NBME explanation:
This patient meets criteria for latent TB infection: positive PPD (≥ 10 mm), negative chest x-ray, and high-risk features (immigration from TB-endemic region and diabetes).
Even with prior BCG vaccination, CDC guidelines state that a positive PPD should be interpreted the same as in non-BCG recipients.
Update: this is also directly relevant to a question on the Step 2 CCSSA Form 9