|
 'DIAGNOSIS
/ EVALUATION'
Initial diagnostic testing for SARS
patients should include chest radiograph, PULSE OXIMETRY, BLOOD CULTURES,
SPUTUM Gram’s attain and culture, and testing for viral respiratory
pathogens, notable influenza A and B and respiratory syncytial virus. A
specimen for Legionella and pneumococcal urinary antigen testing should also
be considered. Clinician should save any available specimens ( respiratory,
blood, and serum) for additional testing until a specific diagnosis is made.
Acute and convalescent (greater than 21 days onset of symptoms) serum
samples should be collected from each patient who meets the SARS case
definition.
Investigations
1. Chest Radiograph
Chest Radiograph might be normal during the febrile prodrome and throughout
the course of illness. However, in a substantial proportion of patients, the
respiratory phase is characterized by early focal interstitial infiltrates
progressing to more generalized, patchy, interstitial infiltrates. Some
x-ray from patients in late stages of SARS also have shown areas of
consolidation.
2. Blood
Investigations
i)
CBC - early in course of disease - the absolute lymphocyte count
is often decreased. Overall white blood cell counts have been normal or
decreased.
At the peak of respiratory illness, approximately 50% of patients
have Leucopoenia, thrombocytopenia or low-normal platelet counts.
ii)
Elevated creatine phosphokinase levels (as high as 3000IV / L) and
hepatic transaminases (2-6 times higher) have been noted.
iii) Renal function test - have been normal in majority of patients.
iv)
Immunological assays -
1. Antibody to SARS - CoV
2. Detection of SARS - CoV by RT-PCR
3. Isolation of SARS - CoV
Treatment Regimens
Treatment regimens have included several antibiotics to presumptively treat
known bacterial agents of a typical pneumonia. In several locations, therapy
also has included antiviral agents such as Oseltamivir or Ribavirin.
Steriods have been administered orally or intravenously to patients in
combination with ribavirin.
At
present, the most efficacious treatment regimen, if any is still UNKNOWN. |
