-
31浏览
-
0点赞
-
0收藏
-
0分享
-
114下载
-
0评论
-
引用
期刊论文
A hospital outbreak of severe acute respiratory syndrome in Guangzhou, China
Chinese Medical Journal 2003; 116(6): 81-818,-0001,():
ObjectiveTo describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches. Methods The outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29.5±10.3) years, 93.8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified. Results (1) The incubation period ranged from 1 to 20 (mean=5.9±3.5) days. The duration of hospitalization was (17.2±8.0) days. (2) The initial temperature was (38.3±0.6) (C, while the highest was (39.2±0.6)℃ (P<0.001), with fever duration of (9.0±4.2) days. (3) Other most common symptoms included fatigue (93.8%), cough (85.4%), mild sputum production (66.7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1.2±0.8 on presentation, which increased to 2.9±1.4 after admission P<0.001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3.5±2.3) days, which increased in size, extent, and severity to the maximum (6.7±3.5) days later. The time before the lung opacities were basically absorbed was (14.9±7.8) days. (5) Leukopenia was observed in 67.7% of this cohort. The time between the onset of fever and leukopenia was (4.4±2.3) days, with the lowest white blood cell count of (2.80±0.72)×10 9/L. (6) The lowest arterial oxygen saturation was (94.8±3.1)% with supplementary oxygen.(7) Antibiotical therapies included tetracyclines (91.0%),aminoglycosides (83.3%), quinolones (79.2%) (18.8% of the patients received a combination of tetracyclines and aminoglycosides, while 11.5% received a combination of tetracyclines and quinolones, and 63.5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13.5% of the patients. (8) 68.8% of the patients were treated with methylprednisolones for a mean interval of (4.9±2.4) days. The initial dose was (67.3±28.2) mg/d and the maximal dose was (82.4±30.5) mg/d.(9) Human globulin, interferon-of antiviral drugs (oral ribavirin or oseltamivir) were used respectively in 68.6%, 46.9% and 92.7% of the patients. (10) Ninety-five patients (99.0%) had a complete clinical recovery, and only 1 patient (1.0%) died. Conclusions SARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvementonchestradiographs. Proper administration of glucocorticosteroids seems to be of some benefits.Antibiotics, human globulin,interferon-o(,andantiviraldrugs, although empirically, might be useful to shorten the clinical course.
【免责声明】以下全部内容由[伍卫]上传于[2009年04月23日 09时00分19秒],版权归原创者所有。本文仅代表作者本人观点,与本网站无关。本网站对文中陈述、观点判断保持中立,不对所包含内容的准确性、可靠性或完整性提供任何明示或暗示的保证。请读者仅作参考,并请自行承担全部责任。
本学者其他成果
同领域成果