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

TitleSevere acute respiratory syndrome (SARS): Chest radiographic features in children
Authors
Issue Date2004
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00247/index.htm
Citation
Pediatric Radiology, 2004, v. 34 n. 1, p. 47-58 How to Cite?
Abstract
Background: 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.
Persistent Identifierhttp://hdl.handle.net/10722/72357
ISSN
2013 Impact Factor: 1.651
ISI Accession Number ID
References

 

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 University of Toronto
DC FieldValueLanguage
dc.contributor.authorBabyn, PSen_HK
dc.contributor.authorChu, WCWen_HK
dc.contributor.authorTsou, IYYen_HK
dc.contributor.authorWansaicheong, GKLen_HK
dc.contributor.authorAllen, Uen_HK
dc.contributor.authorBitnun, Aen_HK
dc.contributor.authorChee, TSGen_HK
dc.contributor.authorCheng, FWTen_HK
dc.contributor.authorChiu, MCen_HK
dc.contributor.authorFok, TFen_HK
dc.contributor.authorHon, EKLen_HK
dc.contributor.authorGahunia, HKen_HK
dc.contributor.authorKaw, GJLen_HK
dc.contributor.authorKhong, PLen_HK
dc.contributor.authorLeung, CWen_HK
dc.contributor.authorLi, AMen_HK
dc.contributor.authorManson, Den_HK
dc.contributor.authorMetreweli, Cen_HK
dc.contributor.authorNg, PCen_HK
dc.contributor.authorRead, Sen_HK
dc.contributor.authorStringer, DAen_HK
dc.date.accessioned2010-09-06T06:40:53Z-
dc.date.available2010-09-06T06:40:53Z-
dc.date.issued2004en_HK
dc.identifier.citationPediatric Radiology, 2004, v. 34 n. 1, p. 47-58en_HK
dc.identifier.issn0301-0449en_HK
dc.identifier.urihttp://hdl.handle.net/10722/72357-
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.en_HK
dc.languageengen_HK
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00247/index.htmen_HK
dc.relation.ispartofPediatric Radiologyen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfanten_HK
dc.subject.meshMaleen_HK
dc.subject.meshRadiography, Thoracicen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - diagnosis - radiography - transmissionen_HK
dc.subject.meshTomography, X-Ray Computeden_HK
dc.titleSevere acute respiratory syndrome (SARS): Chest radiographic features in childrenen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0301-0449&volume=34&spage=47&epage=58&date=2004&atitle=Severe+acute+respiratory+syndrome+(SARS):+chest+radiographic+features+in+childrenen_HK
dc.identifier.emailKhong, PL:plkhong@hkucc.hku.hken_HK
dc.identifier.authorityKhong, PL=rp00467en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00247-003-1081-8en_HK
dc.identifier.pmid14624321en_HK
dc.identifier.scopuseid_2-s2.0-9144253865en_HK
dc.identifier.hkuros87695en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-9144253865&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue1en_HK
dc.identifier.spage47en_HK
dc.identifier.epage58en_HK
dc.identifier.isiWOS:000188114000008-
dc.publisher.placeGermanyen_HK
dc.identifier.scopusauthoridBabyn, PS=7006367819en_HK
dc.identifier.scopusauthoridChu, WCW=7402227871en_HK
dc.identifier.scopusauthoridTsou, IYY=6602162475en_HK
dc.identifier.scopusauthoridWansaicheong, GKL=6603327791en_HK
dc.identifier.scopusauthoridAllen, U=7007010602en_HK
dc.identifier.scopusauthoridBitnun, A=6602414951en_HK
dc.identifier.scopusauthoridChee, TSG=7004196781en_HK
dc.identifier.scopusauthoridCheng, FWT=7202811097en_HK
dc.identifier.scopusauthoridChiu, MC=7101866205en_HK
dc.identifier.scopusauthoridFok, TF=7006455238en_HK
dc.identifier.scopusauthoridHon, EKL=7005164603en_HK
dc.identifier.scopusauthoridGahunia, HK=6602307004en_HK
dc.identifier.scopusauthoridKaw, GJL=6602550492en_HK
dc.identifier.scopusauthoridKhong, PL=7006693233en_HK
dc.identifier.scopusauthoridLeung, CW=7402612619en_HK
dc.identifier.scopusauthoridLi, AM=7403291810en_HK
dc.identifier.scopusauthoridManson, D=7006667566en_HK
dc.identifier.scopusauthoridMetreweli, C=35554459200en_HK
dc.identifier.scopusauthoridNg, PC=7201376998en_HK
dc.identifier.scopusauthoridRead, S=7101661755en_HK
dc.identifier.scopusauthoridStringer, DA=7005319767en_HK

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