Procedures and shingles

[kstarm]

55yr old woman starts valacyclovir for a shingles outbreak two days before I see her for lumbar MBB. Out break is on her forehead. She has a few lesions that are not open. At our procedure site injections are cancelled for active infections. My partner recommended I cancel the injection, and just wait until it has run its course and she finishes the med. I wasn't sure what the best course of action was as I hadn't run into this previously. Anyone else run into this? would you cancel or do the procedure?, does the type of procedure change our decision at all? thanks.

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[willabeast]

i would cancel the MBB. my reasoning is that you cannot be 100% sure this is HZ, and even if it is, it can become super infected with strep or even staph, so doing an elective spine injection would be increasing the risk a little bit. in addition, you might be exposing people in your waiting room/staff to varicella virus although that is a reach i think.

 

[Ducttape]

active lesions i cancel. let her get over her infection, and also dont let the discomfort from shingles affect the results from any scheduled procedure. these are elective procedures, imo.

 

[lobelsteve]

I'd do it. Viral infection away from area being injected. Would not let her put her face on my pillows in the procedure suite.

 

[lonelobo]

It's an MBB , nothing is going get worse with waiting a bit

 

[powermd]

Depends on how much the lesions are bothering her. If they're not bothersome, and the patient doesn't want to waste the visit/travel/time, I'd go ahead and do it.

 

[bronchospasm]

Cancel not because of infection risk but because she is going to be preoccupied by the shingles to focus on the Mbb.

Don't want A false negative.