[Analysis on diagnosis, treatment and influential factors in fever patients during epidemic of severe acute respiratory syndrome]

Abstract

Objective: To analyze the etiology, therapy and influential factors in fever patients during the epidemic of severe acute respiratory syndrome (SARS), so as to define early and differential diagnosis for SARS from other disease with fever.

Methods: The epidemiological and the clinical data of 4060 patients with fever admitted to the emergency department of the Third Hospital affiliated to Peking University from March 5th to May 10th in 2003 were analyzed, and their influential factors were evaluated.

Results: Of 4060 patients with fever 275 cases were admitted to the isolated ward, 145 cases were diagnosed as SARS (3.75 percent), 29 belonged to suspected cases, and in 101 cases SARS was ruled out. Ninety-three cases were non-SARS-pneumonia, 2 were epidemic encephalitis, 8 were epidemic cerebrospinal meningitis, and 3 cases were epidemic hemorrhagic fever.

Conclusion: During epidemic of SARS, the etiology of fever is influenza or other virus infection in 90 percent of patients. Non-SARS-pneumonia and infectious diseases with fever accounted for certain proportion of patients with fever. Our diagnostic level should be improved. SARS could not be ruled out only by a high white blood cells count. Chest X-ray examination have to be repeated, because abnormal chest X-ray do not always appear at the same time with fever.