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Blood on non intact skin
May 8, 2009

In Sept of 2008, I worked a motorcycle accident. The patient had a large head wound with alot of bleeding. He was also very combative. After the patient was tranfer the a helicopter I noticed that my forearms were covered in dry blood. A crew member help clean up my arms with rubbing alcohol. I noticed some burning from what appeared to be scratchs and some active bleeding. The hospital tested the source which was negative. I didn't do the PEP meds because the doctor said the chances were very minimal. He even suggested not continueing the test out to 6 month and a year. I did a follow up test 3 months later for myself, negative.

I had stopped worrying about it after the 3 month test. Since Christmas I have lost 15 lbs without a change in my diet. I kinda blew it off as nothing. But in the past 2 month I have had 2 severe cases of the stomach flu which I rarely have. Do you think this info warrants another test? I have had routine lab work. WBC's were in normal range but I understand that doesn't unless the viral load is high.

Response from Dr. Frascino

Hi,

I would agree that if the source patient tested HIV-antibody negative, PEP would not be recommended for an occupational exposure. For infection to even be a possibility in this case, the source patient would need to be in his "window period." The statistical odds of this being the case are extremely remote.

I would consider your three-month negative HIV test to be definitive. That said I also think you should see your general medical doctor for an evaluation of unintentional weight loss.

Good luck.

Dr. Bob



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