Friday, August 19, 2005

Mystery Meningitis

Another call night hijinx:

We admitted a 48 year old man from the West Coast with 3 weeks of stiff neck, high fever, headache, and new confusion with full-body twitching called myoclonus. Likely meningitis, but unclear what type. The nurses called me at least twice over the night to ask about putting him on contact precautions, and each time I responded that since meningococcus is ruled out due to the length of his illness, standard universal precautions were all that were necessary.

Of course the next morning I come by and he's on full contact precautions. The nurse explains, "but don't you see how sick he is?" Well, yes, but unless you plan to release a swarm of mosquitoes into the room and stand there with him, or to do things which would give you herpes, there's no chance of getting either of the two most likely things he has just by taking care of him.

These days it's easy to get self-righteous about people who are afraid of getting AIDS from handshakes and sharing silverware, but confronted by a poorly understood disease, even fully trained healthcare workers are potentially just a step away from germ hysteria.


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