Question

You are consulted to evaluate a 37-year-old woman who has severely cracked skin on her hands. She preveiously worked in a lab on a n experimental mouse model and one proect involved inject E.coli 057:H7 into the mouse tail veins. One day while injecting animals, the glove on her right hand broke and she contaminated her skin with the bacteria. After decontaminating her skin, as carefully as possible, she went home and subsequently developed severe hemorrhagic diarrhea. She no longer works in the lab and now works in an office but since that experience she has been washing her hands up to 40 times a day to "prevent getting sick". If she doesn't was her hands he gets paralyzed with anxiety

Answer 1

A 37-year-old woman has developed obsessive hand washing after lab exposure to E.coli O157:H7, leading to severely cracked skin. Over-washing can increase infection risk by damaging the skin barrier. Appropriate hand hygiene practices and mental health intervention are necessary to address both her physical and psychological health.

Step-by-step explanation:

Excessive Hand Washing and Its Implications

The context provided describes a situation in which a 37-year-old woman, after an accidental exposure to E.coli O157:H7 in a laboratory setting, has developed a behavior of washing her hands up to 40 times a day due to anxiety of getting sick. This behavior has resulted in severely cracked skin on her hands. Hand washing is indeed a crucial preventive measure against infectious diseases, as it can remove many pathogens from the skin. However, over-washing can lead to damaged skin, which can increase the risk of infection. Health-care workers are at particular risk and need to follow strict protocols to prevent infection, including the use of protective equipment and appropriate hand hygiene practices.

It's important to balance the need for cleanliness with the potential adverse effects of over-washing. In particular, this woman's behavior seems to be driven by anxiety, which suggests the possibility of an underlying mental health concern such as obsessive-compulsive disorder (OCD). Damaged skin barriers, from eczema or psoriasis, can actually facilitate the transmission of pathogens. It is also crucial to use the correct techniques and substances for hand hygiene to minimize harm and maximize effectiveness. For health-care workers, following detailed protocols for managing exposure to pathogens is essential. These protocols include using personal protective equipment, proper hand washing, and sometimes post-exposure treatment with agents like hepatitis B immunoglobulin.

In this context, the use of a 10% bleach solution is recommended by the CDC for disinfecting surfaces, notably when dealing with potential HBV infections. It is also noted that some bacteria have evolved resistance to antibiotics, highlighting the importance of proper hygiene practices to prevent the spread of these resistant strains. This case underscores the need for a careful and informed approach to hygiene and the management of anxiety related to infection risk.