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Have typhoid, Montoux test shows redness. Should I do chest radiology to confirm recurrence of TB?

Hi, wanted a little help regarding TB relapse. I was infected and treated with Pulmanory and Extra pulmonary TB ( Lymph nodes and abdomen) back in 2008. I took a course for 6 months post which my doctor adviced me to dicontinue. Again, in 2010 the TB relapsed since the course was not fully done in 2008. This time I took the complete treatment for 9 months. Post that the sputum culture was negative. Last month I was diagnosed with Typhoid . Just to make sure that TB was not relapsed, I did a chest x-ray which showed fibroses (earlier x-rays in 2008 & 2010 showed the same post treatment). So, I did a sputum APF test and a Montoux was test. The sputum test was negative. However, the Montoux skin test should a 10*8mm redness. I have started the DOTS treatment this time, but one of my family doctors said that Montoux test it only suggestive. Should I also go for chest radiology???? There has been no coughing, weight loss from 69 to 66 i believe is because of typhoid. Appetite loss was only for a week during my Typhoid treatment, no night sweats , fever was experienced only for 3 days and it completely subsided post 1st 2 days of Typhoid treatment. Please suggest.
Asked On : Wed, 24 Oct 2012
Answers:  1 Views:  47
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Pulmonologist 's  Response
Thanks for your query
Your family physician has rightly said the mantoux test is only suggestive and as you had TB in the past mantoux test quite usually can give such result. It doesnot mean TB. You may go for a chest X-ray though i think it will be little contributory as there is already lot of fibrosis. Your sputum is already negative for AFB. In this respect if there is high suspicion of TB then its better to go for BACTEC culture of sputum because it is gold standard. Another test in this clinical context may be vary useful that is TB DNA PCR. If these are positive it will be better to start ATD.
Thank you.
Answered: Thu, 25 Oct 2012
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