[Clinical and chest X-ray characteristics of 5 cases with severe acute respiratory syndrome in children in Shenzhen area].
OBJECTIVE
To explore clinical and chest X-ray features of SARS in children to facilitate correct diagnosis.


METHODS
Clinical manifestations and chest X-ray findings in five children suffering from SARS admitted for treatment in the hospital between February and May, 2003 in Shenzhen area were analyzed. The diagnosis was confirmed by epidemiological, clinical, laboratory and radiological examinations. Among the 5 cases, 1 was a boy and the others were girls at the age of 4 to 13 years.


RESULTS
Of the 5 SARS children, 3 presented a history of close contact with SARS patients. Fever was the initiative symptom, 4 had a body temperature of over 38 degrees C with the highest being 40 degrees C; fever sustained from 4 to 7 days with an average of 5.6 days. All the 5 cases developed nonproductive cough; on auscultation, both moist and dry rales could be heard in 3 out of the 5 cases. Mean total white count of peripheral blood was (2.96 - 6.9) x 10(9)/L, and was < 5.0 x 10(9)/L in 4 cases. SARS associated coronavirus specific RNA fragment was found positive by RT-PCR in 1 case; 1 case was positive for both IgM and IgG antibodies to the virus; 1 case was positive for only IgM antibody and another 2 cases were positive for only IgG antibody. IgG and IgM antibodies to Mycoplasma pneumoniae and Chlamydia pneumoniae as well as blood culture for bacteria were all negative. Findings on chest X-ray examination: 4 cases showed presence of patchy or macular opacities with cord-like shadows in unilateral lung plates while 1 case each showed ground-glass-like opacity and migratory changes; 1 case showed interstitial changes in the lungs in the form of irregular reticular lattice and cord-like shadows. Two cases received CT scanning and macular-patchy or spotty shadows were seen all over the lung. The shortest time for absorption of foci in the lungs was 7 days while the longest was 33 days with a mean of 15 +/- 6 days. None of the cases had any signs of fibrosis in the lungs. All the 5 cases were completely cured and discharged 7 to 40 days (mean 18 +/- 11 days) after admission.


CONCLUSIONS
Compared with adult cases with SARS, children with SARS had milder symptoms and signs. Presence of unilateral patchy shadow in lungs represented the main chest X-ray findings.
Lu
Pu-xuan
PX
Department of Radiology, Shenzhen East Lake Hospital, Shenzhen, 518020 China.
Zhou
Bo-ping
BP
Hu
Yi-wen
YW
Yang
Gui-lin
GL
Yang
Da-guo
DG
Luo
Zi-yi
ZY
Chen
Xin-chun
XC
Gong
Xiao-long
XL
Yang
Gen-dong
GD
Wang
Zhao-qin
ZQ
Yuan
Ben-tong
BT
D000293:Adolescent; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D013902:Radiography, Thoracic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D045473:Severe acute respiratory syndrome-related coronavirus / Q000235:genetics* / Q000276:immunology; D045169:Severe Acute Respiratory Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M