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Case Study
Mrs. Q. is a patient who has been diagnosed with an HIV infection for the past 5 years. During this time, she has been working as a receptionist at an insurance agency. Although HIV is a contagious disease, it cannot be contracted by touching someone, or by sitting next to them. Mrs. Q. has gotten a test done for tuberculin, and it has come back positive. Since this is a very contagious disease, she has chosen to share the results of this test with her office manager because of the risks that she could cause for the other co-workers or customers. Tuberculosis is an infectious disease that affects mainly the lungs, but can still affect all areas of the body. If this disease, Mycobacterium Tuberculosis, is left untreated, the results could lead to death. The vocational implications of Ms. Q results in a positive TB test can be treated, but can eventually affect her employment status.
For most individuals, including Ms. Q’s co-workers and customers, the body’s immune system would likely suppress the disease. It would be necessary however to anyone who had been in close contact with Ms. Q. to be made aware, if she in fact had active TB. Active tuberculosis is actually much less frequent than a tuberculosis infection. With that being said, Ms. Q. would not have been infectious to others unless she had active tuberculosis that had gone untreated. When a healthy immune system is doing its job, TB can lay dormant for years. However, because this disease can be contracted through the air by breathing in droplets expressed when infected individuals cough, it is imperative that those individuals in close contact with Ms. Q. be given the skin test to ensure they have not had a positive reaction to the bacteria. This is especially true in this case, if the disease was active and went unrecognized, and considering that Ms. Q. was not isolated during a possible active period of the infection. Whether the disease is active or latent plays a crucial role in determining



References: American Academy of Family Physicians Retrieved January 14, 2012 http://familyphysicians.org/online/famdocen/home/healthy/safety/work/875.html American Thoracic Society (ATS) and CDC. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161. Retrieved from http://www.cdc.gov/tb/publications/PDF/1376.pdf Frequently asked questions about tuberculosis and hiv. Retrieved from http://data.unaids.org/pub/FactSheet/2006/TB_HIV_QA.pdf Retrieved January 14, 2012 World Health Organization. 2007 Tuberculosis facts Retrieve January 14, 2012 http://www.cdc.gov/hiv/resources/factsheets/hivtb.htm

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