Analysis of the early clinical features in the patients with suspected SARS

Objective:To investigate the clinical features of 58 patients with suspected SARS，and discuss the clinical diagnosis ，evaluation，treatment and outcome.Methods:All the patients with suspected SARS were fulfilled the criteria for suspected SARS.The suspected cases were divided into three class such as the mild，moderate and severe case according to the different clinical features.12patients whose X-ray showed normal or simply has tiny exudation，the gracile layer CT scanning were took.All the patients were treated according to clinical evaluation consisting of antibacterials and a combination of ribavirin，Some moderate cases and all the critical SARS patients used methylprednisolone. immunointensifier and noninvasive ventilation.Results:All 58 cases have a history of exposure to a patient with SARS，fever and fatigue，WBC were normal or lower at first.49patients finally made diagnosis of probable SARS （84.5%），mild pattern were 8cases （16.3%），moderate 34 （69.3%），severe 7（14.2%），death 2 cases（4%）.The patients with mild SARS didn’t have fever and lung shadow disappeared during mean 8.6 admission days.Moderate case had recurred fever for several days，but the shadow disappeared before discharge in 21.3 hospitalize day.In severe patients，Multifocal shadow were involvement and development on the radiographs，noninvasive ventilation were needed.such cases had three peak of high fever in the begin for 2-3 days，second fever during the 6-8 day，the third time was about the two week.The admission duration was more than 30days.The CT showed that there were shadows like clouded glass or consolidation change in 9 cases of 12 patients.Conclusion:As the important monitoring index，fever pattern，white-cell count and changes of radiographic shadow should be investigated in the patients with a novel infectious SARS.Even if the X ray shows normal or tiny exudation，the CT scanning should be taken to make early definite diagnose to the suspected SARS，in order to prevent the plague from exploring.The large dose of steroid can control the clinical development worse，but it may bring some side effect in using inadequately.