Zerr et al. modifying the current clinical diagnostic criteria for sporadic CJD to include the detection of either hyperintensity in the basal ganglia (both caudate nucleus and putamen) or in at least two cortical regions (from either the temporal, parietal or occipital cerebral cortices). This implies that the detection of the specified high signal abnormalities in FLAIR or DWI MRI will be considered at the same level of diagnostic importance as periodic sharp wave complexes on the EEG or 14-3-3 protein detection in the CSF
1996 Case Definition
Hemolytic uremic syndrome (HUS) is characterized by the acute onset of microangiopathic hemolytic anemia, renal injury, and a low platelet count. Thrombotic thrombocytopenic purpura (TTP) also is characterized by these features but can include central nervous system (CNS) involvement and fever and may have a more gradual onset. Most cases of HUS (but few cases of TTP) occur after an acute gastrointestinal illness (usually diarrheal).
The SOFA system was created in a consensus meeting of the European Society of Intensive Care Medicine in 1994 and further revised in 1996. The SOFA is a six-organ dysfunction/failure score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal), providing a daily score of 0 to 24 points. The objective in the development of the SOFA was to create a simple, reliable, and continuous score easily obtained in every institution.
Acute nosocomial pneumonia is broadly defined as pneumonia characterized by a new and persistent infiltrate (radiographically present for greater than 48 hours) PLUS one of the following:
The Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recently reviewed risk factors and developed objective major and minor criteria to identify patients who require direct admission to an Intensive Care Unit (ICU). The most up-to-date definitions use need for invasive mechanical ventilation or septic shock, requiring vasopressors, as absolute indicators for direct admission to an ICU. For patients who do not meet either of these two major criteria, minor criteria have been proposed that are based on CURB-65 and ATS criteria with new additions. For admission to an ICU or high level unit, patients must fulfill at least three of these minor criteria.
After identification of novel influenza A (H1N1) virus infection in Mexico, a case definition was developed. The initial definition of suspected novel influenza A (H1N1) virus infection included any hospitalized patient with severe acute respiratory illness. On May 1, 2009, this definition was expanded to include any person with acute respiratory illness defined as fever and either sore throat or cough. On May 11, 2009, the definition of suspected case was changed again to include any person with:
Clinical picture consistent with tuberculosis; bacteriologic confirmation (culture, gene probe/NAA + AFB smear); histologic findings
Syphilis is a complex sexually transmitted disease that has a highly variable clinical course. Classification by a clinician with expertise in syphilis may take precedence over the following case definitions developed for surveillance purposes.
I. Streptococcal TSS
A. Isolation of group A Streptococcus
1. From a sterile site
2. From a nonsterile body site
B. Clinical signs of severity
2. Clinical and laboratory abnormalities (requires two or more of the following):
a) Renal impairment
c) Liver abnormalities
d) Acute respiratory distress syndrome
e) Extensive tissue necrosis, i.e., necrotizing fasciitis
f) Erythematous rash
An illness with the following clinical manifestations:
Fever: temperature > 38.9º C (102º F)
Rash: diffuse macular erythroderma
Desquamation: 1-2 weeks after onset of illness, particularly palms and soles
Hypotension: systolic blood pressure < 90 mm Hg for adults or less than fifth percentile by age for children <16 years of age; orthostatic drop in diastolic blood pressure greater than or equal to 15 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness