Certain clinical conditions carry a sufficiently high risk to call for the practical application of isolation precautions while waiting for a clear diagnosis. Empiric precautions may be initiated while confirmatory tests are pending (eg, laboratory cultures). The Centers for Disease Control and Prevention's (CDC's) document,
The Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, includes the following syndromes/conditions that warrant empiric transmission-based precautions (always includes Standard Precautions):
- Acute diarrhea with a likely infectious cause in an incontinent or diapered patient. Enteric pathogens may include:
- Enterohemorrhagic Escherichia coli O157:H7
- Shigella species
- Hepatitis A virus
- Noroviruses
- Rotavirus
- Clostridioides difficile
- Petechial/ecchymotic rash with fever or suspected meningitis. Pathogens may include:
- Neisseria meningitidis
- Enteroviruses
- Mycobacterium tuberculosis
- Positive travel history to an area with an ongoing outbreak of viral hemorrhagic fever (VHF) in the ten days before onset of fever. Pathogens may include:
- Ebola virus
- Lassa virus
- Marburg virus
- Vesicular rash. Possible pathogens include:
- Varicella-zoster
- Herpes simplex
- Variola (smallpox)
- Vaccinia viruses
- Maculopapular rash with cough, coryza, and fever. Potential pathogen is rubeola (measles).
- Cough, fever, and pulmonary infiltrate. Possible pathogens may include:
- M. tuberculosis
- Respiratory viruses
- Streptococcus pneumoniae
- Staphylococcus aureus
- Severe acute respiratory syndrome virus (SARS-CoV) and variants
- History of recent travel (10-21 days) to countries with active outbreaks of SARS or avian influenza. Potential pathogens include:
- M. tuberculosis
- Severe acute respiratory syndrome virus (SARS-CoV) and variants
- Avian influenza
- Respiratory infections, particularly bronchiolitis and pneumonia, in infants and young children. Possible pathogens may include:
- Respiratory syncytial virus (RSV)
- Parainfluenza virus
- Adenovirus
- Influenza virus
- Human metapneumovirus
- Severe acute respiratory syndrome virus (SARS-CoV) and variants
- Abscess or draining wound that cannot be covered. Possible pathogens include:
- S. aureus
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Group A Streptococcus
