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Diagnostic Criteria for Sporadic Creutzfeldt-Jakob Disease (sCJD)

8 January, 2010

Classic Creutzfeldt-Jakob Disease (CJD) is a human prion disease. It is a neurodegenerative disorder with characteristic clinical and diagnostic features. This disease is rapidly progressive and always fatal. Infection with this disease leads to death, usually within 1 year of onset of illness. The criteria for clinical diagnosis plus the CSF real-time quaking-induced conversion (RT-QuIC) accurately identifies patients with sCJD (sensitivity 97%, specificity 99%).
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Definition of Postdiarrheal Hemolytic Uremic Syndrome (HUS)

20 November, 2009

1996 Case Definition

Clinical description
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).

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The Sequential Organ Failure Assessment (SOFA) Score

5 November, 2009

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.

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

28 July, 2009

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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Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)

28 July, 2009

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.

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

13 July, 2009

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)

8 March, 2009

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

8 March, 2009

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)

8 March, 2009

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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