Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (574 page)

   Clinical: Meets CDC Clinical Case Definition and epidemiologic link to a case confirmed by culture or PCR

Probable
:

   Clinical: Meets CDC Clinical Case Definition, but not confirmed by culture or PCR, and is not epidemiologically linked to a laboratory-confirmed case. Positive
B. pertussis
DFA or serology supports but does not confirm diagnosis.

Suggested Readings

Best Practices for Health Care Professionals on the Use of Polymerase Chain Reaction (PCR) for Diagnosing Pertussis
. Atlanta, GA: Centers for Disease Control and Prevention; 2012. See:
http://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-pcr-bestpractices.html
. Accessed July, 2013.

Faulkner A, Skoff T, Martin S, et al.
Chapter 10: Pertussis. Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases
, 5th ed. Atlanta, GA: Centers for Disease Control and Prevention; 2012. See:
http://www.cdc.gov/vaccines/pubs/surv-manual/index.html
. Accessed July, 2013.

Loeffelholz MJ, Thompson CJ, Long KS, et al. Comparison of PCR, culture, and direct fluorescent-antibody testing for detection of
Bordetella pertussis
.
J Clin Microbiol.
1999;37:2872–2876.

Tilley PAG, Kanchana MV, Knight I, et al. Detection of
Bordetella pertussis
in a clinical laboratory by culture, polymerase chain reaction, and direct fluorescent antibody staining; accuracy, and cost.
Diagn Microbiol Infect Dis.
2000;37:17–23.

She RC, Billetdeaux E, Phansalkar AR, et al. Limited applicability of direct fluorescent-antibody testing for
Bordetella
sp. and
Legionella
sp. specimens for the clinical microbiology laboratory.
J Clin Microbiol.
2007;45:2212–2214.

   
NONINFECTIOUS RESPIRATORY DISEASES

SARCOIDOSIS

   Definition

   Sarcoidosis is a multiorgan disorder of unknown etiology, characterized by granuloma formation, predominantly in the lungs and intrathoracic lymph nodes. It can affect all individuals with any race, sex, and age, but commonly affects middle-aged adults.

   In the United States, the incidence of sarcoidosis ranges from 5 to 40 cases for 10,0000 populations. The age-adjusted incidence for whites is 11 cases per 10,0000 population. Incidence is higher in African American (34/10,0000) and seems to experience more severe and chronic disease. Also, in African Americans, siblings and parents of sarcoidosis cases have about 2.5-fold increased risk for developing the disease.

   Internationally, the incidence is 20 cases per 10,0000 in Sweden, 1.3 cases per 10,0000 in Japan, and low in China, Africa, India, and other developing countries and could be hidden and misdiagnosed as tuberculosis.

   Incidence peaks in persons aged 25–35 years, and a second peak occurs for women aged 45–65 years. Male-to-female ratio is approximately 2:1. Morbidity, mortality, and extrapulmonary involvement are higher in affected females.

   Several studies have reported on association between environmental factors and occurrence of sarcoidosis. These include wood-burning stoves, tree pollen, soil exposures, inorganic particles, insecticides, and moldy environment. Also, several occupational associations are also observed, that include ship’s servicemen, navy, metal work, building supplies, fire workers, hardware, and gardening materials.

   Who Should Be Suspected?