CDPHE Update on TB

There has been some confusion about TB testing and yearly risk assessments, so I wanted to relay my understanding of the guidance.

Annual skin testing is not recommended. That is, you do NOT need to test residents and staff EVERY year.
HOWEVER……..
Test new admissions and new hires for TB using either a Tuberculin Skin Test (TST) or Interferon Gamma Release Assay (IGRA) upon admission or upon hire if there is no documentation of a previously negative TB test.
Anyone with exposure to TB and symptoms should also be tested (again).
If initial testing comes back negative, you can perform a yearly risk assessment instead of testing the person again.
If initial testing is TB positive, alert the public health department and ensure that the person is treated prior to coming to work.
Go here for further details and watch the video –>TB: Health care personnel screening | Department of Public Health & Environment (colorado.gov)

Healthcare Provider TB Testing Algorithm

Bilateral LE Cellulitis is Rare:

I’ve brought this up before, but this little one pager (below) might say it better than I do.

LE cellulitis is typically unilateral. Bilateral LE cellulitis is rare.
Lymphedema, Stasis dermatitis, Venous Insufficiency (Lipodermatosclerosis), and other types of dermatitis are more often bilateral and might look like bilateral LE cellulitis.
Be concerned about bilateral cellulitis if there is trauma to BOTH legs that might act as a port of entry for bacteria, rapid onset/progression, fever, elevated WBC, bilateral chronic/recurrent wounds of the LE.
Use antibiotics judiciously in cases with bilateral/symmetric LE redness and swelling.