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Guidelines for Referrals to the San Francisco TB Clinic

To refer patients to the San Francisco TB Clinic please complete the interagency TB47 referral form OR provide complete information of your work up and reason for referral on a SFGH consult form or physician letterhead. Those without a referral will not be seen.

 

Printable TB Clinic Referral Criteria

 

We do not accept referrals for:

  • Employment and general TB screening 
  • Asymptomatic patients with prior history of completing LTBI treatment 
  • Asymptomatic patients with positive TST or IGRA (QFT, T-spot), normal chest x-ray, and no special medical condition

 

Referred patients must be residents of the City and County of San Francisco and have one or more of the following criteria for referral:  

  • TB symptoms and suspected of having active TB (regardless of TB test results)
  • An abnormal chest x-ray consistent with old or active TB without prior evaluation or treatment (e.g. chest x-ray with upper lobe
    fibrotic infiltrates)
  • A tuberculin skin test reading ≥ 5 millimeters or positive IGRA (QFT or T-spot) with abnormal or normal cxr and any of the
    following risk factors or special medical conditions:
    • Asymptomatic persons with radiographic evidence of old, healed TB 
    • Contact to active TB cases
    • Converter
    • HIV
    • On immunosuppressive drugs (steroids, cancer chemotherapy, post-transplantation cyclosporine, TNF alpha antagonist
      or other biologic agent)
  • Complicated LTBI treatment:
    • Intolerant of > 1 LTBI regimen and risk factor for progression
    • Viral hepatitis AND - Drug induced hepatitis: LFTs > 3x wnL with symptoms, >5x wnl without symptoms
    • Methadone treatment with risk factor for progression or special medical condition
    • LTBI with immunosuppression and requires DOT
  • Patients without a medical home requiring program or shelter clearance
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