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.
*Source material from Ministry of Health
(China.org.cn April 9, 2003)