Imaging in SARS

Author: A. T. Ahuja; C. G. C. Ooi  

Publisher: Greenwich Medical Media‎

Publication year: 2004

E-ISBN: 9780511206894

P-ISBN(Paperback): 9781841102191

Subject: R563.1 pneumonia

Keyword: 临床医学

Language: ENG

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Imaging in SARS

Description

Severe acute respiratory syndrome (SARS) is a devastating disease and although the virus would appear to have been contained, it is clear that the impact it has had around the world, and could have again in the future, is immense. Hong Kong has been significantly impacted in the recent SARS outbreak, and clinicians and researchers alike have gained a lot of experience in dealing with the disease at short notice. This new book aims to be a state-of-the art update on SARS, with particular reference to imaging, which plays a crucial role in the diagnosis, management and follow-up of patients with the disease (it is widely accepted that SARS patients cannot be managed without imaging and it is included in the WHO's own list of diagnostic criteria for the disease). The book will also provide a perspective on the treatment and experience of the disease outside Hong Kong.

Chapter

Clinical features

Incubation, infectivity and transmission

Incubation period

Period of infectivity

Routes of transmission

Transmission in hospital

Transmission in the community

Superspreaders/superspreading event patient

Prevention and control

Breaking the chain of transmission

Surveillance and reporting

Isolation of patients

Hospital infection control

Contact tracing and isolation of contacts

Management of an outbreak

Public education

Border control measures and travel precautions

Conclusion

References

CHAPTER 2 The Role of Emergency Medicine in Screening SARS Patients

Introduction

Historical background

Questions without answers

Clinical assessment

Staff and patient safety

Definition

Clinical features

Radiography

Laboratory tests

SARS-screening clinic

Guidelines for screening contact subjects

Staff safety

Managing patients with suspected SARS

Hospital admission criteria

Follow-up criteria

Discharge criteria

Conclusion

References

CHAPTER 3 Severe Acute Respiratory Syndrome Outbreak in a University Hospital in Hong Kong

Epidemiology: University Hospital experience

Diagnosis of SARS

Clinical features

Laboratory features [2,6]

Clinical outcomes and prognostic factors

Virological testing for SARS

References

CHAPTER 4 Imaging of Pneumonias

Introduction

Radiographic pattern

Lobar pneumonia

Streptococcus pneumoniae

Klebsiella pneumoniae (Friedlander’s pneumonia)

Legionella pneumophila

Bronchopneumonia

Staphylococcus aureus

Pseudomonas aeruginosa

Haemophilus influenzae

Esherichia coli

Infectious interstitial pneumonia

Viruses

Mycoplasma pneumoniae

Pneumocystis carinii

Mycobacterium tuberculosis

Primary pulmonary TB

Post-primary TB

Non-tuberculosis mycobacteria

Fungal pulmonary infections

Utility of CT

References

CHAPTER 5 The Role of Chest Radiographs in the Diagnosis of SARS

Introduction

Pathological considerations

Role of the CXR in the diagnosis of SARS

Protocol for diagnostic imaging

During the initial outbreak

End of the epidemic

Digital radiography and picture archiving and communication system

CXR appearances

Differential diagnosis

Blind spots for CXRs

Conclusion

References

CHAPTER 6 Chest Radiography: Clinical Correlation and Its Role in the Management of Severe Acute Respiratory Syndrome

Introduction

Treatment protocol

Radiological and clinical patterns during treatment

Radiological pattern during treatment (Figure 6.1)

Clinical pattern during treatment

Radiographic changes and correlation with clinical course

Phase 1

Phase 2

Phase 3

Clinico-radiological correlation

Radiographic changes and clinical outcome

Radiographic changes and laboratory features

Role of CXR in management of SARS

Conclusion

References

CHAPTER 7 The Role of High-Resolution Computed Tomography in Diagnosis of SARS

Introduction

Scanning technique

Indication

Imaging features on HRCT

Appearances

Location

Differential diagnosis

Diagnostic pitfalls

Conclusion

References

CHAPTER 8 The Role of Imaging in the Follow-up of SARS

Introduction

Follow-up presentation of SARS patients

Pathological considerations

Role of imaging in the follow-up of SARS

Chest radiographs and high-resolution CT

Other types of imaging

Imaging appearances

Chest radiograph

HRCT

Patients with major complications

Intensive care patients

SARS patients with evidence of lung fibrosis

Protocol for follow-up imaging

Conclusion

References

CHAPTER 9 Treatment of Severe Acute Respiratory Syndrome

Background

General approach

Clinical outcome

Antiviral agents

Immuno-modulators

Convalescent plasma

Ventilatory support

New treatment

Conclusion

References

CHAPTER 10 SARS in the Intensive Care Unit

Introduction

ICU admission

ICU management and progress

ICU outcome

Infection control

Conclusion

References

CHAPTER 11 Imaging of Pneumonia in Children

Introduction

Chest X-ray and common infective agents

Infants and preschool children

Radiological findings

Viral pneumonia

School-age children

Causes

Radiographic findings

Bacterial pneumonia

Tuberculosis pneumonia

CT and common infective agents

Why is it sparingly used in kids?

CT features

Bacterial infection

Viral infection

Tuberculosis

Evaluation of persistent or recurrent pneumonia

Underlying predisposing conditions

Developmental abnormalities

Complications of pneumonia and role of CT

Parapneumonic effusion/empyema

Necrotizing pneumonia

CT features of compromised and non-compromised lung

Abscess

Pneumatocoele

Other roles of CT

Chronic sequelae and role of CT

Brochiolitis obliterans

Causes

Radiological findings

Swyer–James syndrome

Fibrosis

Bronchiectasis

Conclusion

References

CHAPTER 12 Imaging and Clinical Management of Paediatric SARS

Introduction

Clinical presentation

Problems with World Health Organization definition

Plain radiography

High-resolution computed tomography

Management and outcome

Infection control

Risk stratification and guidelines for paediatric patients

SARS precautions in paediatric wards

Conclusion

References

CHAPTER 13 Imaging of SARS in North America

Introduction

Clinical manifestations of SARS in North America

Radiographic manifestations of SARS in North America

High-resolution CT Findings of SARS in North America

References

CHAPTER 14 Radiographers’ Perspective in the Outbreak of SARS

Introduction

Modification of routine radiographic practice

Plain radiography

CT

Emotional impact of SARS outbreak on radiographers

In the early days of the outbreak

During the outbreak

Towards the end of the outbreak

Radiographers’ perspective in the outbreak of SARS

Reference

CHAPTER 15 Implementation of Measures to Prevent the Spread of SARS in a Radiology Department*

Introduction

Infection control measures to be taken by staff

Staff education

Personal protective apparel

Infection control measures to be taken by patients

General measures to be taken by managers in the radiology department

Patient segregation

Staff education and enforcement of infection control measures

Designate areas for staff to change into personal protective apparel

Showering system

Appointments

Cleaning and disinfection

Staffing arrangements

Resuscitation

Infection control measures for specific modalities

General radiography

CT

Ultrasound

Fluoroscopy/contrast studies

Angiography and interventional radiology

Magnetic resonance imaging

Nuclear medicine

Conclusion

Acknowledgements

References

CHAPTER 16 Aftermath of SARS

Introduction

Audits

Post-SARS sequelae

Musculoskeletal problems

Adrenal insufficiency

Psychological scars

Conclusion

References

CHAPTER 17 Update on Severe Acute Respiratory Syndrome

Introduction

Diagnosis and classification

CDC case definition

Clinical criteria

Epidemiological criteria

Possible exposure to SARS-associated coronavirus (SARS-CoV)

Likely exposure to SARS-CoV

Laboratory criteria

Exclusion criteria

Case classification

SARS RUI

SARS-CoV disease

WHO case definition

Prominence of radiology

Clinical trials

Treatment trials

Imaging trials

Plans for the future

Plans on a global scale

The SARS alert

Plans for the community

Plans for the hospitals

Plans for radiology departments

Conclusion

References

Index

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