Successful triage of suspected hantavirus cardiopulmonary syndrome by peripheral blood smear review: a decade of experience in an endemic region.

Abstract:

OBJECTIVES:In 2001, the University of New Mexico Hospitals implemented a rapid screening tool for the triage of suspected hantavirus cardiopulmonary syndrome based on peripheral blood smear morphology. Five criteria guided clinical decisions: thrombocytopenia, hemoconcentration, granulocytic left shift, absence of toxic changes, and more than 10% immunoblasts. Smears meeting four of five criteria were previously shown to have high predictive value for infection. Our retrospective study aimed to determine clinical performance of this test over the past decade. METHODS:Computerized records of 188 smear results were compared with serology. RESULTS:Receiver operator characteristic curve analysis confirmed that the four of five cutoff was the most clinically useful, with sensitivity and specificity of 89% and 93%, respectively. All patients meeting five of five criteria had confirmed infections. Fifteen discordant results were uncovered, explained by positive subsequent tests in the same patient or severe disease without further testing. CONCLUSIONS:Our findings confirm that peripheral smear analysis is clinically useful in this endemic region.

journal_name

Am J Clin Pathol

authors

Dvorscak L,Czuchlewski DR

doi

10.1309/AJCPNFVWG46NUHED

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

196-201

issue

2

eissn

0002-9173

issn

1943-7722

pii

142/2/196

journal_volume

142

pub_type

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