An assessment of World Health Organization criteria for severe acute respiratory syndrome in patients with cancer

Abstract

Background: The differential diagnosis of severe acute respiratory syndrome (SARS) in patients with cancer can be challenging. Although diagnostic criteria for SARS have been issued by the World Health Organization (WHO), simple adoption of the established criteria may lead to overdiagnosis in patients with cancer or to an increase in the risk of spreading SARS within cancer hospitals.

Methods: The authors report their experience with the exclusion and quarantine of patients with cancer during the peak of the SARS epidemic in Beijing, China. The patients included 4 males and 7 females with a median age of 66 years (range, 39-73 years).

Results: All 11 patients met the WHO diagnostic criteria for probable SARS. Among those 11 patients with probable SARS, only 1 had confirmed SARS; for the other 10 patients, the possibility of SARS infection was ruled out.

Conclusions: Special attention must be paid to patients with cancer who have symptoms similar to those seen in SARS. Although the WHO diagnostic criteria for SARS should be widely accepted, they are not definite or practical in certain populations.

Figure 1

Serial changes in chest X‐rays from a patient with confirmed severe acute respiratory syndrome. (A) Hazy opacities with a ground‐glass appearance are seen in the lower right lobe. (B) Twenty‐four hours later, significant progression is seen in opacities and extent.

Figure 2

Serial changes in chest X‐rays from a patient with probable severe acute respiratory syndrome. (A) Hazy opacities are seen in the lower left lobe. (B) Twenty‐four hours later, after antibiotic therapy, absorbtion of opacities is seen in the lower left lobe.