Which patient should begin treatment for tuberculosis?
a. A patient with HIV and a tuberculin skin test result of a 4-mm region of induration
b. A recent immigrant from a country with a high prevalence of TB with a 10-mm re-gion of induration
c. A patient with no known risk factors who has a job-related tuberculin skin test result of a 12-mm area of induration
d. An intravenous drug abuser with a tuber-culin skin test result of a 5-mm region of induration
B
The immigrant is considered to be at moderate risk, meaning that a 10-mm area of induration on a tuberculin skin test (TST) is considered a positive result. After being evaluated for active TB, this patient should be treated for latent TB. A patient with HIV is considered high risk, but this patient has a negative TST result of less than 5 mm. For a low-risk patient receiving a screening TST for a job, the area of induration must be 15 mm or greater to be considered a positive result. An IV drug abuser is in the moderate-risk category; an area of induration of 10 mm or greater is needed to be considered a positive TST result.
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