UKC

A climbing buddy of mine asked me an interesting question the other day. He started climbing a few years ago and is getting ready to climb at altitude. Recently, he said he tested positive on a tuberculosis test (the skin kind) when he was tested for work and now he is wondering if that whatever he has TB-wise is going to be a problem at higher elevations. Anyone have experience with this?

TB is a complex disease. The tests are also complex. I am sure your friend will end up being thoroughly investigated. If the diagnosis proves correct and when more details are known he may want more specific advice from a mountain medicine expert with access to others with similar expertise. This is best done on a personal basis rather than on an open forum. Any mountain medicine expert can liaise with his personal physician. I suggest if this is the case he contacts the BMC asking for his E mail to be forwarded to their medical advisor.

David Hillebrandt

I agree that talking with a mountain medicine expert is the optimal way to go. The other thing to point out is that having a positive TB skin test does not always mean that one has been exposed to TB in the past. The TB skin test sometimes gives a false positive result if one has been vaccinated to TB in the past via the BCG vaccine or in some other situations. Your friend should consider taking the new and more accurate TB blood test instead:

https://www.accesalabs.com/QuantiFERON-Gold-TB-Blood-Test

The QuantiFERON test is far more accurate when it comes to TB screening.

Quantiferon Gold and similar assays are best used for identifying latent TB, not current active infection. Tuberculin skin testing still has an admittedly limited role, usually when IGRA testing unavailable. 

Agree specialist referral recommended, but I would think it low risk for your friend, especially in the absence of any symptoms of illness. Bear in mind European sanitoria for “consumption” were there because of the altitude - TB doesn’t do well with hypoxia, that’s why they got sent to the mountains! 

B