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¿Tiene este paciente la gripe?

Stephanie A Call¹, Mark A Vollenweider, Carlton A Hornung

¹Department of Medicine, University of Louisville, Louisville, Ky 40202, USA.

|February 25, 2005

Resumen

Los síntomas clínicos por sí solos no son confiables para el diagnóstico de la influenza. Las pruebas de diagnóstico rápido y los datos de actividad de la influenza en toda la comunidad son cruciales para el manejo preciso de los pacientes, especialmente durante la alta demanda de agentes antivirales.

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Área de la Ciencia:

Enfermedades infecciosas Enfermedades infecciosas.
Diagnóstico Clínico El diagnóstico clínico.
Epidemiología La epidemiología.

Sus antecedentes:

La vacunación contra la gripe reduce pero no elimina el riesgo de influenza.
El diagnóstico clínico preciso y rápido de la gripe es esencial para el manejo del paciente, especialmente durante la escasez de antivirales.

Objetivo del estudio:

Revisar sistemáticamente la precisión del diagnóstico de los síntomas y signos de la influenza.
Para evaluar el rendimiento de las pruebas rápidas de diagnóstico de la gripe.

Principales métodos:

Búsqueda sistemática de la literatura de MEDLINE y las bibliografías (1966-2004).
La inclusión de estudios que informan características de funcionamiento de los síntomas / signos frente a un criterio estándar.
Abstracción de datos y estimación de la relación de probabilidad (LR) por dos revisores independientes.

Principales resultados:

Ningún síntoma o signo único confirmó de manera confiable o excluyó la influenza en la población general.
La ausencia de fiebre, tos o congestión nasal disminuyó la probabilidad de influenza (LR < 0,5).
En adultos mayores (≥60 años), las combinaciones de fiebre, tos, aparición aguda, malestar y escalofríos aumentaron la probabilidad de influenza (LR > 2,0).

Conclusiones:

Los hallazgos clínicos por sí solos son insuficientes para el diagnóstico definitivo de la influenza.
Los médicos deben considerar la actividad de la influenza en la comunidad y utilizar pruebas de diagnóstico rápido para tomar decisiones de gestión informadas.