Article: Severe acute respiratory syndrome (SARS): Chest radiographic features in children

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TitleSevere acute respiratory syndrome (SARS): Chest radiographic features in children
AuthorsBabyn, PS6
Chu, WCW3
Tsou, IYY4
Wansaicheong, GKL4
Allen, U6
Bitnun, A6
Chee, TSG4
Cheng, FWT3
Chiu, MC2
Fok, TF3
Hon, EKL3
Gahunia, HK6
Kaw, GJL4
Khong, PL1
Leung, CW2
Li, AM3
Manson, D6
Metreweli, C3
Ng, PC3
Read, S6
Stringer, DA5
Issue Date2004
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00247/index.htm
CitationPediatric Radiology, 2004, v. 34 n. 1, p. 47-58 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00247-003-1081-8
AbstractBackground: Severe acute respiratory syndrome (SARS) is a recently recognized condition of viral origin associated with substantial morbidity and mortality rates in adults. Little information is available on its radiologic manifestations in children. Objective: The goal of this study was to characterize the radiographic presentation of children with SARS. Materials and methods: We abstracted data (n = 62) on the radiologic appearance and course of SARS in pediatric patients with suspect (n = 25) or probable (n = 37) SARS, diagnosed in five hospital sites located in three cities: Toronto, Singapore, and Hong Kong. Available chest radiographs and thoracic CTs were reviewed for the presence of the following radiographic findings: airspace disease, air bronchograms, airways inflammation and peribronchial thickening, interstitial disease, pleural effusion, and hilar adenopathy. Results: A total of 62 patients (suspect = 25, probable = 37) were evaluated for SARS. Patient ages ranged from 5.5 months to 17 years and 11.5 months (average, 6 years and 10 months) with a female-to-male ratio of 32:30. Forty-one patients (66.1%) were in close contact with other probable, suspect, or quarantined cases; 10 patients (16.1%) had recently traveled to WHO-designated affected areas within 10 days; and 7 patients (11.2%) were transferred from other hospitals that had SARS patients. Three patients, who did not have close/hospital contact or travel history to affected areas, were classified as SARS cases based on their clinical signs and symptoms and on the fact that they were living in an endemic area. The most prominent clinical presentations were fever, with a temperature over 38 °C (100%), cough (62.9%), rhinorrhea (22.6%), myalgia (17.7%), chills (14.5%), and headache (11.3%). Other findings included sore throat (9.7%), gastro-intestinal symptoms (9.7%), rigor (8.1%), and lethargy (6.5%). In general, fever and cough were the most common clinical presentations amongst younger pediatric SARS cases (age < 10 years), whereas, in addition to these symptoms, headache, myalgia, sore throat, chills, and/or rigor were common in older patients (age≥10 years). The chest radiographs of 35.5% of patients were normal. The most prominent radiological findings that were observed in the remaining patients were areas of consolidation (45.2%), often peripheral with multifocal lesions in 22.6%. Peribronchial thickening was noted on chest radiographs of 14.5% of patients. Pleural effusion was observed only in one patient (age 17 years and 11.5 months), whereas interstitial disease was not observed in any patient. Conclusion: In pediatric cases, SARS manifests with nonspecific radiographic features making radiological differentiation difficult, especially from other commonly encountered childhood respiratory viral illnesses causing airspace disease. The radiographic presentation of suspected SARS cases ranged from normal to mild perihilar peribronchial thickening. The radiographic presentations, as expected, were relatively more pronounced in the SARS probable cases.
ISSN0301-0449
2011 Impact Factor: 1.674
2011 SCImago Journal Rankings: 0.094
DOIhttp://dx.doi.org/10.1007/s00247-003-1081-8
ISI Accession Number IDWOS:000188114000008
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorBabyn, PS
dc.contributor.authorChu, WCW
dc.contributor.authorTsou, IYY
dc.contributor.authorWansaicheong, GKL
dc.contributor.authorAllen, U
dc.contributor.authorBitnun, A
dc.contributor.authorChee, TSG
dc.contributor.authorCheng, FWT
dc.contributor.authorChiu, MC
dc.contributor.authorFok, TF
dc.contributor.authorHon, EKL
dc.contributor.authorGahunia, HK
dc.contributor.authorKaw, GJL
dc.contributor.authorKhong, PL
dc.contributor.authorLeung, CW
dc.contributor.authorLi, AM
dc.contributor.authorManson, D
dc.contributor.authorMetreweli, C
dc.contributor.authorNg, PC
dc.contributor.authorRead, S
dc.contributor.authorStringer, DA
dc.date.accessioned2010-09-06T06:40:53Z
dc.date.available2010-09-06T06:40:53Z
dc.date.issued2004
dc.description.abstractBackground: Severe acute respiratory syndrome (SARS) is a recently recognized condition of viral origin associated with substantial morbidity and mortality rates in adults. Little information is available on its radiologic manifestations in children. Objective: The goal of this study was to characterize the radiographic presentation of children with SARS. Materials and methods: We abstracted data (n = 62) on the radiologic appearance and course of SARS in pediatric patients with suspect (n = 25) or probable (n = 37) SARS, diagnosed in five hospital sites located in three cities: Toronto, Singapore, and Hong Kong. Available chest radiographs and thoracic CTs were reviewed for the presence of the following radiographic findings: airspace disease, air bronchograms, airways inflammation and peribronchial thickening, interstitial disease, pleural effusion, and hilar adenopathy. Results: A total of 62 patients (suspect = 25, probable = 37) were evaluated for SARS. Patient ages ranged from 5.5 months to 17 years and 11.5 months (average, 6 years and 10 months) with a female-to-male ratio of 32:30. Forty-one patients (66.1%) were in close contact with other probable, suspect, or quarantined cases; 10 patients (16.1%) had recently traveled to WHO-designated affected areas within 10 days; and 7 patients (11.2%) were transferred from other hospitals that had SARS patients. Three patients, who did not have close/hospital contact or travel history to affected areas, were classified as SARS cases based on their clinical signs and symptoms and on the fact that they were living in an endemic area. The most prominent clinical presentations were fever, with a temperature over 38 °C (100%), cough (62.9%), rhinorrhea (22.6%), myalgia (17.7%), chills (14.5%), and headache (11.3%). Other findings included sore throat (9.7%), gastro-intestinal symptoms (9.7%), rigor (8.1%), and lethargy (6.5%). In general, fever and cough were the most common clinical presentations amongst younger pediatric SARS cases (age < 10 years), whereas, in addition to these symptoms, headache, myalgia, sore throat, chills, and/or rigor were common in older patients (age≥10 years). The chest radiographs of 35.5% of patients were normal. The most prominent radiological findings that were observed in the remaining patients were areas of consolidation (45.2%), often peripheral with multifocal lesions in 22.6%. Peribronchial thickening was noted on chest radiographs of 14.5% of patients. Pleural effusion was observed only in one patient (age 17 years and 11.5 months), whereas interstitial disease was not observed in any patient. Conclusion: In pediatric cases, SARS manifests with nonspecific radiographic features making radiological differentiation difficult, especially from other commonly encountered childhood respiratory viral illnesses causing airspace disease. The radiographic presentation of suspected SARS cases ranged from normal to mild perihilar peribronchial thickening. The radiographic presentations, as expected, were relatively more pronounced in the SARS probable cases.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationPediatric Radiology, 2004, v. 34 n. 1, p. 47-58 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00247-003-1081-8
dc.identifier.doihttp://dx.doi.org/10.1007/s00247-003-1081-8
dc.identifier.epage58
dc.identifier.hkuros87695
dc.identifier.isiWOS:000188114000008
dc.identifier.issn0301-0449
2011 Impact Factor: 1.674
2011 SCImago Journal Rankings: 0.094
dc.identifier.issue1
dc.identifier.openurl
dc.identifier.pmid14624321
dc.identifier.scopuseid_2-s2.0-9144253865
dc.identifier.spage47
dc.identifier.urihttp://hdl.handle.net/10722/72357
dc.identifier.volume34
dc.languageeng
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00247/index.htm
dc.publisher.placeGermany
dc.relation.ispartofPediatric Radiology
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshInfant
dc.subject.meshMale
dc.subject.meshRadiography, Thoracic
dc.subject.meshSevere Acute Respiratory Syndrome - diagnosis - radiography - transmission
dc.subject.meshTomography, X-Ray Computed
dc.titleSevere acute respiratory syndrome (SARS): Chest radiographic features in children
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Princess Margaret Hospital Hong Kong
  3. Prince of Wales Hospital Hong Kong
  4. Tan Tock Seng Hospital
  5. National University Hospital, Singapore
  6. Hospital for Sick Children, Toronto