Smallpox diagnostic criteria: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
For the [[diagnosis]] of [[smallpox]], the [[CDC]] along with other organizations, elaborated a group of major and minor criteria:<ref name="MooreSeward2006">{{cite journal|last1=Moore|first1=Zack S|last2=Seward|first2=Jane F|last3=Lane|first3=J Michael|title=Smallpox|journal=The Lancet|volume=367|issue=9508|year=2006|pages=425–435|issn=01406736|doi=10.1016/S0140-6736(06)68143-9}}</ref><ref name="pmid15546084">{{cite journal| author=Seward JF, Galil K, Damon I, Norton SA, Rotz L, Schmid S et al.| title=Development and experience with an algorithm to evaluate suspected smallpox cases in the United States, 2002-2004. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 10 | pages= 1477-83 | pmid=15546084 | doi=10.1086/425500 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15546084 }} </ref> | For the [[diagnosis]] of [[smallpox]], the [[CDC]] along with other organizations, elaborated a group of ''major'' and ''minor criteria'':<ref name="MooreSeward2006">{{cite journal|last1=Moore|first1=Zack S|last2=Seward|first2=Jane F|last3=Lane|first3=J Michael|title=Smallpox|journal=The Lancet|volume=367|issue=9508|year=2006|pages=425–435|issn=01406736|doi=10.1016/S0140-6736(06)68143-9}}</ref><ref name="pmid15546084">{{cite journal| author=Seward JF, Galil K, Damon I, Norton SA, Rotz L, Schmid S et al.| title=Development and experience with an algorithm to evaluate suspected smallpox cases in the United States, 2002-2004. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 10 | pages= 1477-83 | pmid=15546084 | doi=10.1086/425500 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15546084 }} </ref> | ||
====Major==== | ====Major==== | ||
*On any singular part of the body, there | * On any singular part of the body, there need to be [[lesions]] in the same stage of development | ||
*Characteristic [[pustules]]: | * Characteristic [[pustules]]: | ||
**Well circumscribed and round | ** Well circumscribed and round | ||
**Confluent or with a depression in the middle | ** Confluent or with a depression in the middle | ||
*[[Fever]] occurring approximately 1-4 days before [[rash]] begins | * [[Fever]] occurring approximately 1-4 days before [[rash]] begins | ||
**The [[fever]] is usually > | ** The [[fever]] is usually >102 degrees Fahrenheit (T ≥38.3ºC) | ||
*With [[fever]], at least one of the following [[symptoms]]: | * With [[fever]], at least one of the following [[symptoms]]: | ||
**[[Malaise]] | ** [[Malaise]] | ||
**[[Abdominal pain]] | ** [[Abdominal pain]] | ||
**[[Vomiting]] | ** [[Vomiting]] | ||
**[[Chills]] | ** [[Chills]] | ||
**[[Back pain]] | ** [[Back pain]] | ||
**[[Headache]] | ** [[Headache]] | ||
====Minor==== | ====Minor==== | ||
*Patient appears [[toxic]] or near death | *Patient appears [[toxic]] or near death | ||
*Initial lesions will be on the [[oral mucosa]] | *Initial lesions will be on the [[oral mucosa]] and [[face]], progressing in a centrifugal fashion towards the arms and feet | ||
*There will be lesions on the palms and soles | *There will be lesions on the palms and soles | ||
*Most of the lesions will be on the [[distal]] extremities and face | *Most of the lesions will be on the [[distal]] extremities and face | ||
*Evolution of [[rash]] from [[macules]] to [[papules]], to [[pustules]], and finally to scabs | *Evolution of the [[rash]] from [[macules]] to [[papules]], to [[pustules]], and finally to scabs | ||
===Diagnostic Algorithm=== | ===Diagnostic Algorithm=== | ||
Revision as of 18:55, 13 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
The diagnosis of smallpox is guided by an algorithm, elaborated by the CDC, that follows certain major and minor criteria.
Diagnosis
For the diagnosis of smallpox, the CDC along with other organizations, elaborated a group of major and minor criteria:[1][2]
Major
- On any singular part of the body, there need to be lesions in the same stage of development
- Characteristic pustules:
- Well circumscribed and round
- Confluent or with a depression in the middle
- Fever occurring approximately 1-4 days before rash begins
- The fever is usually >102 degrees Fahrenheit (T ≥38.3ºC)
- With fever, at least one of the following symptoms:
Minor
- Patient appears toxic or near death
- Initial lesions will be on the oral mucosa and face, progressing in a centrifugal fashion towards the arms and feet
- There will be lesions on the palms and soles
- Most of the lesions will be on the distal extremities and face
- Evolution of the rash from macules to papules, to pustules, and finally to scabs
Diagnostic Algorithm
Below is an algorithm aimed to guide the diagnosis of smallpox:
References
- ↑ Moore, Zack S; Seward, Jane F; Lane, J Michael (2006). "Smallpox". The Lancet. 367 (9508): 425–435. doi:10.1016/S0140-6736(06)68143-9. ISSN 0140-6736.
- ↑ Seward JF, Galil K, Damon I, Norton SA, Rotz L, Schmid S; et al. (2004). "Development and experience with an algorithm to evaluate suspected smallpox cases in the United States, 2002-2004". Clin Infect Dis. 39 (10): 1477–83. doi:10.1086/425500. PMID 15546084.