Maartens et al reported two clinical prediction rules for Pneumocystis jirovecii pneumonia (PjP) in HIV patients who are seriously ill. One rule uses the patient's respiratory rate in the decision-making. The authors are from University of Cape Town, South African Medical Research Council, National Health Laboratory Service and University College London.
Patient selection: seriously-ill HIV positive patient with pneumonia
Parameters:
(1) chest X-ray appearance
(2) hemoglobin in g/dL
(3) respiratory rate in breaths per minute
Parameter
Finding
Points
chest X-ray
PjP unlikely
0
PjP possible or likely
2
hemoglobin
< 9 g/dL
0
>= 9 g/dL
1
respiratory rate
< 30
0
30 to 39
1
40 to 49
2
>= 50
3
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of PjP.
Score
Percent with PjP
0
0
1
3%
2
7%
3
13%
4
25%
5
43%
6
62%
Performance:
• The area under the ROC curve was 0.76.
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