Smallpox diagnostic criteria
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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 a CDC algorithm that follows certain major and minor criteria.
Diagnosis
For the diagnosis of smallpox, the CDC along with other organizations, created a group of major and minor criteria:[1][2]
Major Criteria
- 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 Criteria
- 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.
- ↑ "Public Health Image Library (PHIL), Centers for Disease Control and Prevention" (PDF).