Epelboin et al reported a score for evaluating a patient with community-acquired pneumonia for the risk of Q fever pneumonia in a region with a high prevalence of Q fever. This can help to guide additional testing and the choice of antibiotics. The authors are from Centre Hospitalier Andree Rosemon, Institut Pasteur de Guyane, Centre Hospitalier Pitie-Salpetriere, Universite Montpellier and Universite de la Mediterranee.
Patient selection: community-acquired pneumonia in French Guiana
Parameters:
(1) sex
(2) age in years
(3) headache
(4) leukocyte count in 10^9/L
(5) serum CRP concentration in mg/L
Parameter
Finding
Points
sex
female
0
male
2
age in years
< 30 years
0
30 to 60 years
2
> 60 years
0
headache
absent
0
present
2
leukocyte count
< 10 * 10^9/L
2
>= 10 * 10^9/L
0
CRP
<= 185 mg/L
0
> 185 mg/L
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the risk for Q fever pneumonia.
Total Score
Risk Group
Percent with Q fever pneumonia
0 to 3
low
4%
4 to 6
intermediate
13%
7 to 9
high
65%
Performance:
• A score <= 3 had a negative predictive value of 97%.
• The median area under the ROC curve was 0.83.
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