Haemorrhagic-fever-like changes and normal chest radiograph in a doctor with SARS.
A 33-year-old doctor contracted severe acute respiratory syndrome presenting with features of disseminated intravascular coagulopathy without changes in the chest radiograph initially. A CT scan of his chest showed marked lung changes. His condition improved with intravenous methylprednisolone 500 mg daily and ribavirin 1.2 g orally thrice daily. The case illustrates the importance of a break in fever between the viraemic and lung inflammatory phases of the illness that occurs before radiographic changes and which may obscure diagnosis. Careful quarantine and follow-up of these patients are necessary. Coagulopathy is usually uncomplicated and early CT of the chest may elucidate hidden lung changes and facilitate a rapid diagnosis.
Department of Medicine, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People's Republic of China. ebwu@I-cable.com <ebwu@I-cable.com>
Eugene B
EB
Wu
Joseph J Y
JJ
Sung
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005334:Fever / Q000209:etiology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D045169:Severe Acute Respiratory Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D013997:Time Factors