A 5 year old patient presents to your office for a physical to start school.

A 5 year old patient presents to your office for a physical to start school. She recently immigrated from Guatamala and reports being healthy and feeling well today. Her vaccination record reflects that she is UTD with her vaccines, however to enter school she needs a PPD. You place the Tuberculosis SKin test an deducate the family that they must return to your office in 48-82 hours to read the results. The patient returns two days later with a 13mm of induration. What are your next steps? Sign her physical papers. She is cleared to begin school Begin INH and Rifapentine and report case to local health department Send the patient for a chest x ray for confirmation of active or latent disease Repeat the TST and compare reaction

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