Cunha et al reported a score for diagnosing swine influenza (H1N1) pneumonia. The authors are from Winthrop University Hospital in Mineola and the State University of New York at Stonybrook in New York.
Patient selection: adults hospitalized for influenza-like pneumonia and a negative rapid influenza diagnostic test
Parameters:
(1) myalgia
(2) lymphocyte count
(3) serum CK
(4) serum liver function tests (ALT, AST)
(5) platelet count
(6) heart rate
(7) white blood cell (WBC) count
(8) atypical lymphocytes
(9) serum ferritin
(10) serum phosphate concentration
|
Parameter |
Finding |
Points |
|
myalgias |
none to moderate |
0 |
|
|
severe |
5 |
|
lymphocyte count |
normal or elevated |
0 |
|
|
lymphocytopenia explained by another cause |
0 |
|
|
lympocytopenia not explained by another cause |
5 |
|
serum CK |
normal |
0 |
|
|
elevated but explained by another cause |
0 |
|
|
elevated not explained by another cause |
5 |
|
serum ALT and AST |
normal |
0 |
|
|
elevated but explained by another cause |
0 |
|
|
elevated not explained by another cause |
2 |
|
platelet count |
normal or elevated |
0 |
|
|
thrombocytopenia explained by another cause |
0 |
|
|
thrombocytopenia not explained by another cause |
2 |
|
heart rate |
normal or elevated |
0 |
|
|
bradycardia explained by another cause |
0 |
|
|
bradycardia not explained by another cause |
-5 |
|
WBC count |
normal or elevated |
0 |
|
|
leukopenia mixed |
0 |
|
|
leukopenia alone explained by another cause |
0 |
|
|
leukopenia alone not explained by another cause |
-2 |
|
atypical lymphocytes |
none or rare |
0 |
|
|
present |
-1 |
|
serum ferritin |
normal |
0 |
|
|
elevated <= 2 times upper limit of normal (ULN) |
0 |
|
|
elevated > 2 times ULN |
-5 |
|
serum phosphate |
normal or elevated |
0 |
|
|
hypophosphatemia explained by another cause |
0 |
|
|
hypophosphatemia not otherwise explained |
-3 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: -16
• maximum score: 19
• The higher the score the more likely the patient has H1N1 pneumonia.
|
Total Score |
H1N1 Pneumonia |
|
< 10 |
unlikely |
|
10 to 15 |
possible |
|
16 to 19 |
probable |
Specialty: Infectious Diseases, Pedatrics
