Severe acute respiratory syndrome
Background
- SARS = Severe Acute Respiratory Syndrome
- Mainly Asia
- Commonly isolated from civet cat
- Coronavirus spread by respiratory droplet transmission
Differential Diagnosis
Influenza-Like Illness
- Influenza
- URI
- Pneumonia
- Sinusitis
- Toxic exposure
- Pyelonephritis
- Bronchitis
- Coronavirus
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
Causes of Pneumonia
Bacteria
- Gram-positive
- Gram-negative
- Haemophilus influenzae
- Klebsiella pneumoniae
- Escherichia coli
- Pseudomonas aeruginosa
- Moraxella catarrhalis
- Atypical pneumonia
Viral
- Common
- Influenza
- Respiratory syncytial virus
- Parainfluenza
- Rarer
- Adenovirus
- Metapneumovirus
- Severe acute respiratory syndrome (SARS)
- Middle east respiratory syndrome coronavirus (MERS)
- 2019-nCoV (COVID-19)
- Cause other diseases, but sometimes cause pneumonia
Evaluation
- 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
References
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