Saturday, January 26, 2013

Worrisome PPD

Nagsusumigaw na positive! 

That’s how I describe my PPD test. A whopping 20mm induration. Super positive talaga, considering that it only needs to be more than 10mm induration for healthworkers, and an induration of more than 5mm for an HIV positive person to say that the test is positive.

The intradermal (ID) injection was done by the nurse and pinuri ko pa nga siya for a painless ID administration. Usually kasi ID’s are painful since maraming nerve endings under the superficial layer of our skin. Kaya siya masakit. But, the way the nurse administered it, hindi mahapdi

The only time a skin test was done to me was when we had our return demonstration on the different routes of administration of medicines back when I was still a student. I remember distilled water lang yung ginamit namin for the skin test. Sino nga ba naman ang may allergy sa tubig para mag-positive sa skin test na yun.

24 hours post PPD test.
And so, a day has passed, and this is how it looked like. (Sorry, the measurement of the induration, the smaller darker circle, is supposedly perpendicular to the position of the arm. Mali yung position ng ruler ko. My bad!)

First day pa lang, I knew it was something different. It started to hurt a bit lalo pag tinatamaan. The redness grew larger and larger.

Ganito pala ang feeling ng PPD testing. Usually kasi, I see patients come in, for checking na lang of their PPD. But the actual process of the reaction, hindi ko naman nao-observe. Ngayon pa lang talaga, first hand observation pa. And this is one hell of a worrisome PPD test.

48 hours post PPD test.
 Here's the picture of my forearm 48 hours after the administration of the PPD. It was painful and a bit swollen. Mabigat sa pakiramdam lalo when I let my arm loose.

During this time and only until 72 hours after the administration of the PPD, pwede na basahin ng doctor kung ano yung result.

Like I have said, it was exceptionally large. If I were to read the result, I know it's positive. But of course, I still have it checked by the doctor in RITM. And unanimous ang decision. The induration was measured. 20mm. It was positive.

Sabi ni doc na nag-read ng PPD ko, maganda raw yung pagkakabigay ng PPD sa'kin. So tanggal na yung nurse factor sa mga dahilan kung bakit nagkaganito yung PPD ko.

I was actually a bit kabado kasi ayaw ko magkaroon ng TB. I don't want to, because that would mean I have to require all the other members of the family who lives with me na mag-prophylaxis against TB para hindi sila mahawa. And that would entail a lot of questions and discussions with my parents and siblings.

Pero, not because I turned out positive in PPD, may tuberculosis na ko. My chest X-ray was normal. And I was still waiting for the result of my sputum AFB. Of course, the latter is more definitive than a positive PPD test.

1 week post PPD test.
This was taken a week after my PPD test. The redness around the induration has subsided. Still indurated, I think I accidentally removed a part of the whitish covering kaya it appeared to have a hole. Until eventually, the covering was peeled off which exposed the healing wound. Nagmukha tuloy toxic-looking yung PPD ko that time. From a normal skin test, naging sugat na siya. Kainis!

Itong part na nga lang ng braso ko ang proud ako na makinis at maputi, magkakapeklat pa. At napakalaking peklat pa. Very noticeable. Damned talaga!

Since madaling mapuna, my mom and dad have been asking kung ano daw ba 'to. I just told them na sugat lang na matagal gumaling. I don't know if bumebenta yun. As to what caused the wound, I have no idea what to tell them. Hindi naman nila tinatanong pa

The wound is too perfectly round to reason out na accidental burn siya. Kunwari natalsikan ng mantika while cooking. Hindi kapani-paniwala. Mas maniniwala pa siguro sila if I'd say na it was intentional. Kaso why would I do such a thing naman.

One of my friend doctor remarked, "Naku, alam ko yan! PPD test yan eh, and nag-positive ka!"

What the f***?! She's good! Of course, we are supposed to know. Kunwari na lang I wasn't paying attention to her when she said that. Hindi ako sumagot. Bahala na sila whatever they think this is.

2 weeks post PPD test.
 Two weeks have passed and accidentally natanggal na naman yung scab ng sugat. (Would you believe me when I say that the scab was accidentally peeled off lang talaga? Haha!). I thought it would already be dry. Ayan, looked like hindi pa rin pala. And up to this time, it is still indurated.

By this time, nakuha ko na yung result ng sputum AFB ko. It was negative naman for acid fast bacilli. Negative for the bacteria causing the tuberculosis.

Big sigh of relief. Wala akong TB. And ang naiisip ko lang na most likely reason for my worrisome PPD test is my exposure to other people with TB infection when I was having my duty in the hospital.

Nonetheless, I am now on prophylaxis against TB. I have been taking Isoniazid 300mg/tab once daily which I will have to take for 6 months para hindi na ako ma-infect in the near future.

I do hope it still heals like as if it has not been there, parang wala lang nangyari. But  I doubt. For sure, it will be leaving an ugly scar. On second thought, naisip ko na mas okay na magkaroon ako ng malaking peklat sa braso, huwag lang magkaron ng peklat sa baga dahil sa TB.

P.S.: To my adorable friend (gaya-gaya na ako ng tawag sa'yo) who loves touching my wound... Okay lang yan hawak-hawakan. Hindi ka mahahawa. :)



  1. ah yun pala mangyayari dun. napag-aralan lang namin yan pero di ko rin alam kung ano nangyayari.. bigla ko tuloy naalala yung R-I-P-E-S for TB. Nagreply ako sa email.

  2. yup, ang alam ko lang din before was reading the result... ndi ko alam na ganyan ang process lalo pag nagpositive ka sa PPD.. haha!

  3. hanga ako dun sa nurse painless and Intradermal. almost lhat ata ng pinoy pag ng ppd test magppositive kasi expose tayo sa tb ekek.. confirmatory ang afb.. tama b doki hehe.. good thing negative afb mo dok :D... ingat lage doki

    1. kaya nga akala ko nung una, mali, masyado malalim.. e sabi naman ni doc, maganda daw pagkakaadminister kaya sige na nga tama na sya...

      yep, super exposed sa ppd.. ewan ko ba, ndi naman reliable ang ppd... nakakasira lang ng balat... ang panget na ng braso ko.. sagwa lang...

      thanks thanks Pong! :)

  4. My doc also asked me to have a PPD skin test and it turned out negative naman. From what she told me, PPD is just an exposure to TB test but, you're right, hindi naman ibig sabihin noon you have TB already. There is this one test that my first doc asked me to take alongside sputum test, yung TB culture and sensitivity test. Yun daw kasi yung, and I quote her, "gold standard" in detecting TB. :)