Justice
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An 18-year-old female college student is brought to the emergency department by her friends because of altered mental status and fever. She was well until several hours ago, when she began complaining of a headache.
On physical examination, she is obtunded. Temperature is 39.0 °C (102.2 °F). She is tachycardic and hypotensive and has multiple petechiae and some purpura over her lower extremities. Her lungs are clear. Abdominal examination is normal.
An emergency department intern intubates the patient for airway protection. The intern did not have time to put on a mask while doing this procedure. A nurse, who is wearing only gloves, starts peripheral intravenous access for hydration and antibiotics. A radiology technician obtains a portable chest film. The chaplain visits briefly in the patient’s room.
Following these procedures, lumbar puncture is performed, which reveals Neisseria meningitidis.
Which of the following hospital personnel requires meningococcal post-exposure prophylaxis?
A. The nurse
B. The radiology technician
C. The intern
D. The chaplain
E. All of the above
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| dr.wad
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E
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| ganesha123
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E
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| sandra
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neisseria is spread by droplet infection. i remember reading somewhere tht health care providers who come in close contact like... giving mouth to mouth respiration or intubation alone needs prophylaxis.. so only the intern needs prophylaxis here, i guess. whtz the ans justice?
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| doc_clotaire
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Yep , The Washington Manual says :
only health care workers having close contact with secretion , e.g intubation should recieve prophylaxis with RIF 600 mg PO bid for 2 days
So , in that case I would pick :
C. The intern
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| cool doctor
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C
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| Jcala
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According to The Sanford Guide to Antimicrobial Therapy.. Only close contacts.
C
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| liliaeliz
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c
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| Markus2009
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C
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| Justice
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The correct answer is C
Neisseria meningitidisinfection is common in communal living settings such as dormitories. The organism is transmitted via close contact with an infected patient’s respiratory secretions. Post-exposure prophylaxis is recommended for household contacts and for those health care workers and other hospital personnel who had close contact with the patient’s respiratory secretions. Only the intern who intubated the patient without personal protective equipment is at increased risk of contracting meningococcal disease. The nurse, the radiology technician, and the chaplain did not have close contact with this patient’s respiratory secretions and do not require chemoprophylaxis.
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| guangyu
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nice question
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