Civil Surgeons
Civil Surgeon Tuberculosis Screening Medical Examination for All Applicants 2 Years of Age or Older

Top of chart begins: “Civil surgeon (CS) conducts a medical history, physical examination, and IGRA test on applicant*”
- If “IGRA Negative”, then “No Class A or Class B TB”
- If “IGRA Positive”, then “Chest x-ray”
- If “Chest x-ray Negative”, then “B2, Latent TB Infection”, then “Required LTBI report to health department*”
- If “Chest x-ray Positive”, then “Referred to health department for sputum smears and cultures”
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- If “Negative Cultures”, then “Applicant returns to CS Class B1, Pulmonary TB”
- If “Positive Cultures”, then “Class A TB Disease Applicant must complete treatment”, then “Applicant returns to CS after treatment. CS reclassifies as Class B0, Pulmonary TB”
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- If “Signs or symptoms of TB or known HIV infection”, then “Chest x-ray”, then “Referred to health department for sputum smears and cultures”
- If “Negative Cultures”, then “Applicant returns to CS Class B1, Pulmonary TB”
- If “Positive Cultures”, then “Class A TB Disease Applicant must complete treatment”, then “Applicant returns to CS after treatment. CS reclassifies as Class B0, Pulmonary TB”
* Interferon gamma release assay (IGRA), Latent tuberculosis infection (LTBI)
Page last reviewed: February 4, 2019