Severe acute respiratory disease

Introduction Severe Acute Respiratory Syndrome: It is called "atypical pneumonia" before the cause is identified. Infectious atypical pneumonia, also known as Severe Acute Respiratory Syndromes (SARS), is a main symptom of fever, dry cough and chest tightness caused by SARS-associated coronavirus. Respiratory failure is a new respiratory infection. The strong infectivity and rapid progression of the disease are the main features of the disease.

Cause

The cause of severe acute respiratory disease

It refers to pneumonia caused by mycoplasma, chlamydia, legionella, rickettsia, adenovirus and other unidentified microorganisms.

an examination

Related inspection

Respiratory syncytial virus antibody lung ventilation imaging

Severe acute respiratory disease check

1. Epidemiological history

1.1 Two weeks before the onset of illness, there have been close contact with similar patients or evidence of a clear transmission to others.

1.2 Living in an epidemic area or 2 weeks before the onset of illness has been in areas where SARS is prevalent.

2. Symptoms and signs: fever (>38 ° C) and cough, respiratory acceleration, shortness of breath, or respiratory distress syndrome, lung rales or more than one of the signs of lung consolidation.

3. Laboratory examination: The early blood WBC count does not increase, or decrease.

4. Pulmonary imaging examination: different degrees of flaky, patchy infiltrating shadows or reticular changes in the lungs.

5. Antibiotic treatment has no obvious effect.

Clinical diagnosis of SARS: clinical diagnosis based on epidemiological data, symptoms and signs, laboratory tests, and pulmonary imaging examinations of the case. Once the pathogen is determined, the detection method is specific, that is, the epidemiological data of the confirmed case is established. , symptoms and signs, laboratory tests, lung imaging examinations comprehensive judgment for clinical diagnosis, once the pathogen is determined, the detection method is specific, that is, establish the definition of the diagnosis.

Diagnostic Criteria for SARS Severe Cases: One of the SARS cases that meet the following criteria can be diagnosed as a severe case of SARS:

1. Multi-leaf lesions or X-ray films showed a progression of >50% within 48 hours.

2. Difficulty breathing, respiratory rate > 30 beats / min.

3. Hypoxemia, 3-5 liters of oxygen or oxygenation index <300 mmHg.

4. Shock, ARDS or MODS (multiple organ dysfunction syndrome).

Obviously, since SARS is caused by a virus, any antibiotics that are effective against bacteria have no obvious effect on the disease.

Traditional "atypical pneumonia" may be caused by pathogens such as mycoplasma, chlamydia, rickettsia, or by rare bacteria, may be sensitive to macrolide antibiotics, ie macrolides Antibiotics (ie erythromycin) can be treated as a specific drug.

However, if the "atypical pneumonia" in the traditional sense is also caused by a virus, the antibiotic is also ineffective. At this time, if antibiotics are used, it is an abuse of antibiotics.

Differential diagnosis

Symptoms of suspicion of severe acute respiratory illness

The increase in the regulatory body temperature (more than 0.5 ° C) caused by the up-regulation of the body temperature setting point due to the action of the pyrogen is called fever. Each person's normal body temperature is slightly different and is affected by many factors (time, season, environment, menstruation, etc.). Therefore, it is better to judge whether it is fever or not, and it is better to compare it with the body temperature under the same conditions. If you do not know your original body temperature, the temperature of the armpit (tested for 10 minutes) exceeds 37.4 °C and can be determined to be fever. Cough is a protective respiratory reflex that removes secretions or foreign bodies from the respiratory tract. Although it has its beneficial side, severe long-term cough can cause respiratory tract bleeding. Correctly distinguish between general cough and cough variant asthma to prevent misdiagnosis.

SARS critical diagnosis criteria

According to the epidemiological data, symptoms and signs, laboratory tests, and pulmonary imaging examination of the case, the clinical diagnosis is carried out. Once the pathogen is determined, the detection method is specific, that is, the epidemiological data, symptoms and signs of the confirmed case are established. Laboratory tests and pulmonary imaging examinations are comprehensively judged for clinical diagnosis.

One of the SARS cases meets the following criteria and can be diagnosed as a severe case of SARS:

1. Multi-leaf lesions or X-ray films showed a progression of >50% within 48 hours.

2. Difficulty breathing, respiratory rate > 30 beats / min.

3. Hypoxemia, 3-5 liters of oxygen or oxygenation index <300 mmHg.

4. Shock, ARDS or MODS (multiple organ dysfunction syndrome).

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