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1. Medical History 1.1 The patient has had close contact with Severe
Acute Respiratory Syndrome (SARS) patients or similar cases in recent two weeks,
or there is accurate evidence of SARS cases that have infected this patient.
1.2 The patient is living in or has visited a SARS epidemic-stricken area in
the past two weeks. 2. Symptoms and Pathology A fever of 38?C or higher,
which is associated with more than one of the following pathological signs:
cough, tachypnea, dyspnea, respiratory distress syndrome, moist rales, and
pulmonary consolidation. 3. Laboratory Examination No white blood cell
(WBC) count rise, it may even decreases. 4. Pulmonary Imaging Examination
Reticular change, flaky or striped infiltrative shadows in varying degrees
found in the lungs. 5. Little effect shown after using antibiotics.
Clinical Diagnosis of SARS Once the source of the disease is identified
and clinical examinations are made based on the patient's medical history,
symptoms and pathology, laboratory examination, and pulmonary imaging
examination, a definite diagnosis can be made.
Suspected Case of SARS: 1.1+2+3 or 1.2+2+3+4
Clinically Diagnosed Case of SARS: 1.1+2+3+4 or 1.2+2+3+4+5
Clinical Diagnostic Criteria for Serious Case of SARS
Any case of SARS meeting one of the following criteria can be diagnosed as a
serious case of SARS: 1. Pathological changes have occurred in multiple lung
lobes, or chest radiographs show the focus of infection has expanded over 50
percent within 48 hours. 2. The patient has difficulty breathing, with a
respiratory frequency of more than 30 times per minute. 3. The patient
suffers from hypoxemia. Under the condition of inhaling oxygen of 3-5 l/m, the
patient's SaO2 is less than 93 percent, and oxygenation index less than 300
mmHg. 4. The patient suffers from shock, acute respiratory distress syndrome
(ARDS) or multiple organ dysfunction syndrome (MODS). Notes:
1. "Close contact" means nursing or visiting a SARS patient, co-living with a
SARS patient (including hospitalization), or directly touching a SARS patient's
respiratory tract secretion and body fluid. 2. "SARS-stricken area" refers
to a region where cases of primary SARS have occurred and caused spread of the
illness. It does not include regions where the imported SARS cases have occurred
and caused certain spread of the illness. 3. A SARS patient may have
symptoms of headache, joints pains, malaise, myalgia, thoracodynia, and
diarrhea. 4. While diagnosing and treating SARS cases, doctors should rule
out the possibility of other lung diseases with similar clinical manifestations,
such as primary bacterial or fungal pneumonia, pulmonary tuberculosis (TB), lung
tumor, non-infective interstitial lung diseases (ILD), pneumonedema,
atelectasis, pulmonary embolism, pulmonary infiltration with eosinophilia, and
pulmonary angeitis. |
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