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Atypical pneumonia (SARS)

The epidemic situation on incidence of "atypical pneumonia" in the world continues to become complicated. According to operational WHO data as of 28.04.2003 in 29 countries of the world 5050 cases of a heavy acute respiratory syndrome (SARS) from which 321 died are registered.

WHO defined unsuccessful regions:
- Canada (Toronto)
- Singapore  (Singapore)
- China (all territory)
- The USA (regions are not specified)
- Great Britain (London)

The greatest number of the diseased is revealed in China - 2914, died-131, Hong Kong - 1557, died - 133. Cases of SARS are registered in Vietnam, Taiwan, Thailand, Malaysia, Germany, Switzerland, Italy, Spain, Romania, Ireland, Belgium, Sweden, France, Australia, Brazil.

Considerable part of the diseased - health workers and persons who provided medical care by primary patient - age of sick from 25 to 70 years.

The etiological agent of atypical pneumonia is not finalized. Consider that the activator are the isolated viruses from family of paramyxoviruses and coronaviruses.

The incubation interval makes from 5 to 6 days, is rare till 10 days.


Main clinical signs of SARS: fervescence is higher than 38 degrees, cough, short wind, a breath utrudneniye - in addition to the main symptoms cases of SARS are followed also by other signs: fever, headache, mialgiya, weakness, appetite loss, sometimes rashes and diarrhea.

Objective status: obtusion of a pulmonary sound at percussion, at auscultation of lungs - weakening of breath, rattles, crepitation are possible.

At X-ray inspection infiltrates at first limited come to light, then they merge.

At blood test at early stages of a disease norm, or a leykotsitopeniya, a lymphopenia. Further the leykotsitopeniya and thrombocytopenia develops, kreatinfosfokinaza level to 3000 units of 2-6 times increases the ALT, nuclear Heating Plant level increases.

At statement of the diagnosis of SARS it is necessary to consider existence of close contact for the last 10 days with free BARS-and at which pneumonia radiological is confirmed.

Treatment of atypical pneumonia: WHO recommends to use anti-virus drugs, in particular riboverin. In hard cases intravenously steroid hormones in a complex with riboveriny and antibiotics for prevention of bacterial complications.

Criteria of statement of the diagnosis of SARS

Suspicious case:
- an acute respiratory syndrome at the person who in the last 10 days was in the struck region of the world;
- an acute respiratory syndrome at the person who in the last 10 days was in contact with the patient, suspicious on SARS disease;
acute respiratory syndrome of not clear genesis which is followed by fervescence higher than 36 degrees, dry cough, difficulty of breath, short wind, sometimes diarrhea.
Probable case:
existence of signs which are classified as a suspicious case;
existence on the roentgenogram of symptoms of focal or intersticial pneumonia;
leukopenia, lymphopenia, thrombocytopenia, increase of level of activity of transaminases;
impossibility to establish a disease etiology.

 
"Aspergillosis of lungs   African trypanosomiasis"