If a Mantoux test is positive, what is the next appropriate step to evaluate for active TB?

If a Mantoux test is positive, what is the next appropriate step to evaluate for active TB?

• A. Order a chest radiograph to evaluate for active TB
• B. Reassure that the test is negative
• C. Refer to an infectious disease specialist
• D. Question about potential exposure to homeless persons

Answer: (A)

A positive Mantoux shows TB infection, but it doesn’t prove there is active disease. The next step is a chest radiograph to look for signs of active TB, such as focal infiltrates, consolidation, cavitation, or regional lymph node involvement. This imaging helps distinguish active pulmonary TB from latent infection and guides the next steps, like collecting sputum or respiratory samples for smear and culture and possibly rapid molecular tests. If the radiograph is normal, clinicians still evaluate symptoms and risk factors, but imaging is the appropriate immediate next move. Reassuring the test is negative, referring to an infectious disease specialist right away, or focusing on a specific exposure claim does not address the need to assess for active disease with imaging and lab testing.

A positive Mantoux shows TB infection, but it doesn’t prove there is active disease. The next step is a chest radiograph to look for signs of active TB, such as focal infiltrates, consolidation, cavitation, or regional lymph node involvement. This imaging helps distinguish active pulmonary TB from latent infection and guides the next steps, like collecting sputum or respiratory samples for smear and culture and possibly rapid molecular tests. If the radiograph is normal, clinicians still evaluate symptoms and risk factors, but imaging is the appropriate immediate next move. Reassuring the test is negative, referring to an infectious disease specialist right away, or focusing on a specific exposure claim does not address the need to assess for active disease with imaging and lab testing.