Clinical Predictors of Fiumefreddo et al for Legionella Pneumonia in the Emergency Department

Description

Fiumefreddo et al identified factors predictive of Legionella pneumonia in patients presenting with community-acquired pneumonia. This can help guide initial antibiotic therapy while more definitive tests are pending. The authors are from University Hospital Basel and Kantonsspital Aarau in Switzerland.

Patient selection: community-acquired pneumonia in the Emergency Department

Parameters:

(1) body temperature

(2) sputum production

(3) serum sodium concentration

(4) serum concentration of LDH

(5) serum C-reactive protein (CRP)

(6) platelet count

Parameter	Finding	Points
body temperature	<= 39.4°C	0
	> 39.4°C	1
sputum production	present	0
	absent	1
serum sodium concentration	>= 133 mmol/L	0
	< 133 mmol/L	1
serum LDH	<= 225 IU/L	0
	> 225 IU/L	1
serum CRP	<= 187 mg/L	0
	> 187 mg/L	1
platelet count	>= 171,000 per µL	0
	< 171,000 per µL	1

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

• A score >= 2 was associated with Legionella pneumonia.

Performance:

• The area under the ROC curve is 0.86.

• For a cutoff >=2, the sensitivity was 78% and specificity 79%.

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Clinical Predictors of Fiumefreddo et al for Legionella Pneumonia in the Emergency Department

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