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Case Reports
, 361 (9368), 1520-1

Haemorrhagic-fever-like Changes and Normal Chest Radiograph in a Doctor With SARS

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Case Reports

Haemorrhagic-fever-like Changes and Normal Chest Radiograph in a Doctor With SARS

Eugene B Wu et al. Lancet.

Abstract

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.

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