Table 2 - Clinical Syndromes or Conditions Warranting Additional Empiric Precautions to Prevent Transmission of Epidemiologically Important Pathogens Pending Confirmation of Diagnosis*2

Table 2 Clinical Syndromes or Conditions Warranting Additional Empiric Precautions to Prevent Transmission of Epidemiologically Important Pathogens Pending Confirmation of Diagnosis*
Clinical Syndrome or Condition†		Potential Pathogens‡	Empiric Precautions

Diarrhea
	Acute diarrhea with a likely infectious cause in an incontinent or diapered patient	Enteric pathogens§	Contact
	Diarrhea in an adult with a history of recent antibiotic use	Clostridium difficile	Contact
Meningitis		Neisseria meningitidis	Droplet
Rash or exanthems, generalized, etiology unknown
	Petechial/ecchymotic with fever	Neisseria meningitidis	Droplet
	Vesicular	Varicella	Airborne and Contact
	Maculopapular with coryza and fever	Rubeola (measles)	Airborne
Respiratory infections
	Cough/fever/upper lobe pulmonary infiltrate in an HIV-negative patient or a patient at low risk for HIV infection	Mycobacterium tuberculosis	Airborne
	Cough/fever/pulmonary infiltrate in any lung location in a HIV-infected patient or a patient at high risk for HIV infection (23)	Mycobacterium tuberculosis	Airborne
	Paroxysmal or severe persistent cough during periods of pertussis activity	Bordetella pertussis	Droplet
	Respiratory infections, particularly bronchiolitis and croup, in infants and young children	Respiratory syncytial or parainfluenza virus	Contact
Risk of multidrug-resistant microorganisms
	History of infection or colonization with multidrug-resistant organisms\|\|	Resistant bacteria\|\|	Contact
	Skin, wound, or urinary tract infection in a patient with a recent hospital or nursing home stay in a facility where multidrug-resistant organisms are prevalent	Resistant bacteria\|\|	Contact
Skin or Wound Infection
	Abscess or draining wound that cannot be covered	Staphylococcus aureus, group A streptococcus	Contact
* Infection control professionals are encouraged to modify or adapt this table according to local conditions. To ensure that appropriate empiric precautions are implemented always, hospitals must have systems in place to evaluate patients routinely according to these criteria as part of their preadmission and admission care. † Patients with the syndromes or conditions listed below may present with atypical signs or symptoms (eg, pertussis in neonates and adults may not have paroxysmal or severe cough). The clinician's index of suspicion should be guided by the prevalence of specific conditions in the community, as well as clinical judgment. ‡ The organisms listed under the column "Potential Pathogens" are not intended to represent the complete, or even most likely, diagnoses, but rather possible etiologic agents that require additional precautions beyond Standard Precautions until they can be ruled out. § These pathogens include enterohemorrhagic Escherichia coli O157:H7, Shigella, hepatitis A, and rotavirus. \|\|Resistant bacteria judged by the infection control program, based on current state, regional, or national recommendations, to be of special clinical or epidemiological significance.

Contents

Updated: February 18, 1997

Table 2 Clinical Syndromes or Conditions Warranting Additional Empiric Precautions to Prevent Transmission of Epidemiologically Important Pathogens Pending Confirmation of Diagnosis*

Table 2
Clinical Syndromes or Conditions Warranting Additional Empiric Precautions to Prevent Transmission of Epidemiologically Important Pathogens Pending Confirmation of Diagnosis*