A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy.
What is the appropriate next step in management for this patient?
A- Repeat the PPD test and x-ray after 6 months
B- Start treatment with isoniazid for 9 months
C- Start treatment with multiple drug- antituberculosis therapy
D- Isolation and full antituberculous therapy for 6 months
This man has a previous exposure to TB, which caused subclinical infection. His history, physical examination and chest x-ray exclude current active TB. He does not need multiple drug treatment at this time but he should take a prophylactic treatment in case there is any dormant infection in his body. The prophylactic treatment for this case is isoniazid for 9 months.
The correct answer is B