Clinical Diagnostic Criteria for Hospital-Acquired (or Nosocomial) Pneumonia (HAP)

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:

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Case Definition for Influenza A (H1N1) Virus Infection (Swine Flu)

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:

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1996 CDC Case Definition for Syphilis (Treponema pallidum)

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.

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Case Definition of Streptococcal Toxic-Shock Syndrome (Streptococcal TSS) and Necrotizing Fasciitis

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

1. Hypotension

2. Clinical and laboratory abnormalities (requires two or more of the following):

a) Renal impairment

b) Coagulopathy

c) Liver abnormalities

d) Acute respiratory distress syndrome

e) Extensive tissue necrosis, i.e., necrotizing fasciitis

f) Erythematous rash

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Case Definition of Staphylococcal Toxic Shock Syndrome (TSS)

An illness with the following clinical manifestations:

  1. Fever: temperature > 38.9º C (102º F)

  2. Rash: diffuse macular erythroderma

  3. Desquamation: 1-2 weeks after onset of illness, particularly palms and soles

  4. 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

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Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders

A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:

Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.

Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.

Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following:

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Diagnostic Criteria for Acute Pharyngitis

Adults

Clinical suspicion of streptococcal pharyngitis (e.g., fever, tonsillar swelling, exudate, enlarged/tender anterior cervical lymph nodes, absence of cough or coryza) with

  • History of rheumatic fever or
  • Documented household exposure or
  • Positive rapid strep screen

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