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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does No AFB In Smears Mean Free Of TB?

Good day.. I am a nurse applying in a small family hospital.. They have requested me to have a medical exam as one of the requirements of employment.. When I got the result of the c-xr, it says there that I have minimal kochs infection.. They ask me to have a 3 day AFB smear.. I got the result and it says there that no AFB seen in all of the smears.. Am I free of TB? Will this affect my future application to other institutions? I am scared please help me..
Mon, 6 Oct 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM. I am seeing lot many patients with similar problems in my practice. If chest x ray is showing infiltration and sputum for AFB is negative, it is not 100% accurate that you are not having TB. This report may be false negative as your infiltration is small. I followthis protocol in my papatients.
1. CT Thorax with contrast.
2. Bronchoscopy and BAL analysis.
Both these are more superior and accurate than chest x ray and sputum.
So I suggest you to consult pulmonologist and discuss these things.
BAL will help you in identifying infection other than TB as well if at all present.
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Does No AFB In Smears Mean Free Of TB?

Thanks for your question on HCM. I am seeing lot many patients with similar problems in my practice. If chest x ray is showing infiltration and sputum for AFB is negative, it is not 100% accurate that you are not having TB. This report may be false negative as your infiltration is small. I followthis protocol in my papatients. 1. CT Thorax with contrast. 2. Bronchoscopy and BAL analysis. Both these are more superior and accurate than chest x ray and sputum. So I suggest you to consult pulmonologist and discuss these things. BAL will help you in identifying infection other than TB as well if at all present.