Table 1.
Winthrop-University Hospital Infectious Disease Division's point system for diagnosing severe influenza A in adults (modified)
| Symptomsa | Point Score | Signsa | Point Score | Laboratory Testsa | Point Score |
|---|---|---|---|---|---|
| Hyperacute onset | +3 | Fever (>39°C/102°F) | +2 | Leukocytosisc | −5 |
| Severe prostration | +5 | Dry cough | +1 | Leukopenia | +3 |
| Generalized muscle aches | +3 | Conjunctival suffusion | +5 | Relative lymphopenia | +3 |
| Retro-orbital pain | +5 | Hemoptysis | +3 | Thrombocytopenia | +3 |
| Severe back of neck/lumbar aches | +5 | Localized ralesb | −3 | Chest radiograph | |
| Cyanosis | +5 | No/minimal infiltrates (<48 hours) | +3 | ||
| Bilateral patchy infiltratesb (>48 hours) | +5 | ||||
| Focal/segmental infiltratesb | −5 | ||||
| Likelihood of severe influenza A | |||||
| Total points | >20 = Severe influenza A highly probable 10–20 = Mild/moderate influenza A likely <10 = Influenza A unlikely |
||||
Adapted from Cunha BA. The clinical diagnosis of severe viral influenza A. Infection 2008;36:92–3; Cunha BA. Pneumonia essentials. 3rd edition. Sudbury (MA): Jones & Bartlett; 2010.
a
Otherwise unexplained, acute, and related to influenza.
b
Unless with bacterial CAP.
c
Leukocytosis without relative lymphopenia and thrombocytopenia.