Radiographic features of a case of severe acute respiratory syndrome with fatal outcome.

Tan, D Y; Kaw, G J; Tsou, I Y; Wansaicheong, G K; Green, J A; Tai, D Y; Chee, T S

INTRODUCTION Severe acute respiratory syndrome (SARS) is a new form of atypical pneumonia caused by a coronavirus. We present the clinical course and chest radiographic findings of a case of SARS with fatal outcome. CLINICAL PICTURE A 39-year-old Chinese male presented with fever, sore throat and non-productive cough. During his illness, serial chest radiographs showed increasingly severe air-space shadowing in both lungs. TREATMENT AND OUTCOME The patient was treated with supplemental oxygen, levofloxacin, oseltamivir, ribavirin and methylprednisolone. As his condition worsened, the required ventilatory and inotropic support. He later developed a myocardial infarct and coagulopathy, and succumbed to his illness. CONCLUSION The reported case mortality of SARS is about 9% worldwide. In Singapore, the mortality is 15.5%. Acute respiratory distress syndrome (ARDS) is believed to be a contributory factor to our patient's demise. We report this case to show the radiographic changes of ARDS in a patient with SARS.