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Q. I am scared of getting an infection from the hospital. Am I overthinking?

 

Hello doctor,

I had an ENT examination and the specialist did not use gloves but, did not touch the part going into the nose the first time. The tubing, the second time it went up my nose, was touched at the bottom by her at the light. I am very OCD usually and watched this happen but, somehow trusted her as she is well respected. She had used hand sanitizer when she came in but shook my hand. Having been at another doctor's myself prior and registering my thumbprint on the check-in, I did use hand sanitizer twice after. But, I was holding a clean plastic cup from the water cooler with what I believe, was a clean tissue to hold the cup. She then did the procedure the second time having touched the tip of the scope with the fingers. She wrote back to me saying she will change her ways.

The PCP is under the same system and asked me not to worry but, agreed to do the testing when I pushed. What tests should I have? Should I wait to get symptoms? Again, I am not sure she even used the wall sanitizer. I am asking the PCP to do an HIV and MRSA test. What else should I have her test me for? I am not vaccinated against Hepatitis B. Should I ask for a TB test? Does a general staph culture exist to rule out colonization? I work with children in talk therapy. So, I want to be sure I do not have anything communicable. I know it is hard to tell. But, I am panicking. What tests would you suggest? In what priority? Please be kind. I am already blaming myself for not speaking up. I can barely get up in the morning. I anxiously await your response. Thank you.

 

Dr.Ashaq Hussain Parrey
MBBS., MD
General Medicine, Internal Medicine, Rheumatology

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

  • You seem to be overly concerned about hygiene. That could indicate an OCD (obsessive compulsive disorder). I will try to explain each of the infections that you have mentioned.
  • MRSA (methicillin-resistant Staphylococcus aureus) is a hospital-acquired infection and occurs in people who are hospitalized and have an underlying illness like an immunocompromised state or are receiving broad-spectrum antibiotics.
  • The organisms present on the skin are called commensals. They are present in you as well as on your treating doctor. So, they cannot infect you.
  • HIV (human immunodeficiency virus), Hepatitis C and Hepatitis B spread through the blood, serum or semen of an infected person to a non-infected person, if the infected body fluids come in contact with a wound from where it can enter the blood. It does not spread by skin contact.
  • You do not need to get tested for anything, and I assure you that you are not infected with any of the above. What you do need is behavior therapy by a psychologist for your OCD, so that you do not become more antisocial.

Regards.

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Thank you doctor,

I was on broad spectrum antibiotics for 20 days. First, for a molar extraction and then for a nasal swelling. I was taking 875 mg twice a day until four days before the ENT exam and a course of 500 mg twice a day for the extraction, and the gum graft was still open and healing. So was that a possible entry way? Is there a general test for staph colonization in the nose? I do not want to spread anything to my patients while exchanging paperwork, appointment cards and playing games with the children in therapy. I appreciate what you are saying regarding OCD but, what communicable disease could I have gotten that would spread to family or patients, through close skin contact given the situations. What about TB? If the doctor shakes hands with all her patients and only uses hand sanitizer before, could she not have touched a contaminated tool or hand prior and spread the contamination to the tube that went into the mucosal lining of the nose? Why do doctors wear gloves typically then or use a sanitizer at all if there are no communicable risks? I really want to protect those I love and work with more than just worry about myself. I am only looking to prevent the spread of anything to others. I look forward to your reply.

 

Dr.Ashaq Hussain Parrey
MBBS., MD
General Medicine, Internal Medicine, Rheumatology

Hello,

Welcome back to icliniq.com.

Well, your concern is genuine and I appreciate your care for people. 

  • Few organisms may spread through contact with the mucous membranes if it is a penetrative injury. They include virus mostly like hepatitis C and B, and rarely HIV.
  • Tuberculosis spreads by droplet infection and rarely through inoculation were it can cause a localized infection. Influenza virus may also spread this way but, usually manifests in less than 72 hours with symptoms of upper respiratory tract infection.
  • You can get a nasal swab for staph and influenza, serology test for Hepatitis B and C and HIV after six weeks. However, many of them have a window period where they may be negative initially. So a repeat test will be necessary after six months. 

Having said all this, it is very unlikely that you contracted any infection because most doctors care about their patients as you do.

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Regards.

For more information consult a general medicine physician online --> https://icliniq.com./ask-a-doctor-online/general-medicine-physician

 
 
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