Haemorrhagic-fever-like changes and normal chest radiograph in a doctor with SARS

Lancet. 2003 May 3;361(9368):1520-1. doi: 10.1016/S0140-6736(03)13170-4.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Disseminated Intravascular Coagulation / etiology*
  • Fever / etiology*
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Radiography
  • Severe Acute Respiratory Syndrome / complications*
  • Severe Acute Respiratory Syndrome / diagnostic imaging*
  • Time Factors