0%
Topic
Review Topic
0
0
N/A
N/A
Questions
2 2
0
0
Topic
Snapshot
  • A 34-year-old woman presents to a local hospital in the United States with a week history of fevers, headaches, myalgias, and nonproductive cough. She stated she started having a nonproductive cough yesterday. Two weeks ago, she traveled to Hong Kong to visit relatives. She visited a nursing home a couple of times but did not have any sick contacts. On physical exam, she is diaphoretic and her oxygen saturation is 93% on room air. A chest radiograph reveals bilateral pulmonary infiltrates. A rapid influenza antigen test is negative. She is admitted for further management.
Introduction
  • Classification
    • coronavirus (CoV)
      • an enveloped, linear, positive, single-stranded RNA virus with a helical capsid
      • causes the “common cold” as well as severe acute respiratory syndrome (SARS) and Middle Eastern respiratory syndrome (MERS)
        • SARS-CoV
        • MERS-CoV
      • transmission via respiratory secretions
  • Epidemiology
    • incidence
      • worldwide
      • MERS-CoV
        • countries around the Arabian Peninsula
      • SARS-COV
        • Asia
    • demographics
      • all ages
    • risk factors
      • recent travel to the Arabian Peninsula or Asia
      • sick contacts
      • immunosuppression
      • healthcare workers
  • Pathogenesis
    • replication in tracheobronchial epithelium
  • Prognosis
    • worse prognosis
      • higher respiratory virus titer
      • older age
      • underlying comorbidities

 

Presentation
  • Symptoms
    • MERS/SARS presents more acutely and severely than the common cold, often requiring hospitalization
    • prodrome
      • fever and chills
      • malaise
      • myalgias
      • nausea and vomiting
      • headache
    • respiratory phase
      • nonproductive cough
      • shortness of breath
      • sore throat
Imaging
  • Chest radiography
    • indication
      • MERS/SARS
    • findings
      • bilateral pulmonary infiltrates
Studies
  • Labs
    • detection of viral RNA on reverse-transcriptase polymerase chain reaction
    • serum antibody on enzyme-linked immunosorbent assay
    • may have increased lactate dehydrogenase
  • Making the diagnosis
    • based on clinical presentation and confirmed with laboratory evaluation
Differential
  • Influenza
    • distinguishing factors
      • systemic symptoms predominate
      • rapid antigen detection test for influenza is positive
Treatment
  • Management approach
    • treatment is typically supportive
  • Conservative
    • supportive
      • indication
        • all patients
      • modalities
        • supplemental oxygen
        • hydration
Complications
  • Hypoxemic respiratory failure
Topic Rating

Please rate topic.

Average 4.8 of 4 Ratings

 

Questions (2)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Topic COMMENTS (0)
Private Note