186 Chapter 8 11. Exacerbation cystic fibrosis (CF) Prerequisite: the patient has a medical history of CF. Exacerbation CF An acute or sub-acute exacerbation of the symptoms the patient normally experiences: 3. Patient has at least one of the following: worsening of dyspnea, hemoptysis, cough or wheezing, or more mucus production or more purulent sputum [8] AND 4. Additional treatment was started. Exception: • All CF patients with a pneumonia or other LRTI, should be labelled “Exacerbation CF” as well as “Pneumonia” or “Other LRTI”. That is, if the patient has a medical history of CF and presents at the ED with pneumonia, he or she should automatically be labelled both “Pneumonia” and “Exacerbation CF”, irrespectively of the treatment that might or might not be started for the exacerbation. However, this does not apply for concurrent sinusitis or other upper respiratory tract infection. When a patient has an exacerbation of CF and sinusitis or other upper respiratory tract infection, additional treatment for the exacerbation should have been started in order to assign both diagnostic labels. References: [8] 12. Pleural effusion or empyema Please consider the following three options: 1. The radiology report describes abundant pleural effusion: this case should be referred to the Adjudication Committee. 2. The radiology report describes slight or moderate pleural effusion and there is no conclusive other diagnosis: this case should be referred to the Adjudication Committee. 3. The radiology report describes slight or moderate pleural effusion and there is another conclusive diagnosis (pneumonia, heart failure, or lung tumor): the label pleural effusion is not assigned and only the conclusive diagnosis is labelled. References: [9, 10] 13. Atelectasis Please consider the following two options: 1. The radiology report concludes lobar or segmental atelectasis: this case should be referred to the Adjudication Committee. 2. The radiology report concludes linear (plate, band, discoid, subsegmental) atelectasis: this case should not be referred to the Adjudication Committee and should not be labelled “Atelectasis”. Exception: • In case of pre-existing lobar or segmental atelectasis, the case does not need to be referred to the Adjudication Committee and should not be labelled “Atelectasis”.
RkJQdWJsaXNoZXIy MTk4NDMw