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Yep. I'm an Idiot.

Apr 30, 2012

I am a student doing lab rotations. Unfortunately this week, I got two total drops of blood and urine from separate patients in my eye after recapping an ESR tube and a urine tube. There were no eye goggles available for staff or shields to protect staff from potential exposures. I was so in shock and embarrassed that I didn't wash my eye out or report the incident to anyone. A couple of days after the exposure I had a fever, swollen lymph glands, a sore throat with chills and a productive cough. The symptoms subsided after a couple of days, leading me to think exposure could have been the result of the cold my husband had recently. Given that such mucosal transmission rates are relatively low but still plausible, my current plan of action is to order an HIV and Hep C test at the 1 month,3 month, and 6 month mark to screen for a potential exposure. I recently had unprotected sex with my husband who apparently didn't care about the risk. I realize this was a stupid decision, but I obviously was oblivious in the heat of the moment(damn hormones). Are there any symptoms I should watch out for if he was exposed to the virus or any advice you can give me to prevent further exposures? I now am wearing glasses to every rotation regardless if the staff wears them or not. Healthcare is obviously not as white and fuzzy as it appears to be on the surface. It's really cool to look at a disease until it splashes you in the face. Any parental advice you can give me other than insulating myself in a giant bubble and avoiding contact with anything in medicine again?

Response from Dr. Young

Hello and you're not an idiot.

There is no one (or group of) symptom that is diagnostic of acute HIV infection. As such, I wouldn't leap to the conclusion that the fever, swollen lymph notes or sore throat are necessarily anything else than the dozens of sore throats that you might have had prior to doing your lab rotation.

I think that your monitoring plan is sound, but frankly based on your exposure, if the 3 month test is negative.... you're negative.

Now, as for insulating bubbles. Many of us proudly provide HIV care, and have so for a long time (and remain HIV negative). Use this event as that "teachable moment" that we all talk about-- learn (really, learn) what universal precautions is all about; then practice them. Healthcare is a lot of warm and fuzzy stuff, but also filled with lots of warm, personal experiences.


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