Severe acute respiratory syndrome

Background

• SARS = Severe Acute Respiratory Syndrome
• Mainly Asia
  • Commonly isolated from civet cat
• Coronavirus spread by respiratory droplet transmission

Clinical Features

• Fever, Chills
• Myalgias
• Headache
• Non-productive cough

Differential Diagnosis

Influenza-Like Illness

• Influenza
• Parainfluenza
• URI
• Pneumonia
• Sinusitis
• Toxic exposure
• Pyelonephritis
• Bronchitis
• Coronavirus
  • MERS-CoV
  • SARS-CoV
  • 2019-nCoV (COVID-19)

Cough

Acute (< 3 wks)

• URI (rhinitis, sinusitis, pertussis)
• LRI (bronchitis, pneumonia)
• Influenza
• Allergy
• Asthma
• Environmental irritants
• Transient airway hyperresponsiveness
• Foreign body
• SARS

Chronic (> 8 wks)

• Postinfectious; pertussis
• Smoking and/or chronic bronchitis
• Postnasal discharge
• Asthma
• GERD
• ACEI/ARB
• CHF
• Lung cancer or intrathoracic mass
• Emphysema
• Interstitial lung disease
• Psychiatric

Diagnosis

• CXR (abnormal in 75% of cases at presentation)
  • Patchy consolidation in peripheral lung fields

A chest X-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS

Management

• Empiric treatment for Bacterial Pneumonia
• Ribavirin
• Methylprednisolone

Disposition

• Admit

See Also

Cough