I'm sorry to bother you with this question but last week during rounds, there was an Hiv + patient with an enlarged inguinal lymph node and I tought: No broken skin, I'll touch it.. It was hypertermic and tender.. after that i saw no fluids on my fingers, in one of them i had a small paper cut. But the thing is that one of the clinical residents seemed to freak out and screamed that next time i should wear gloves...

Since then i became very paranoid because i feel i can't trust my judgement... Was this a careless thing to do?

Hi,

Actually your judgment is fine; it's the screaming clinical resident that is at fault here. (I'm sure he or she meant well.) Examining an HIV-positive patient requires gloves only when there is non-intact skin or possible exposure to infectious bodily fluids. Palpating adenopathy (enlarged lymph nodes) does not require a latex barrier. You were not careless. Your resident either overreacted or is woefully misinformed. You should discuss the issue with an HIV-knowledgeable attending physician at your hospital. He should then advise the resident regarding appropriate universal precautions.

Dr. Bob