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{{MERS}}
{{MERS}}
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{{CMG}}; {{AE}} {{JS}}


==Overview==
==Overview==
[[MERS|Middle East Respiratory Syndrome]] ([[MERS]]) is a [[viral]] [[respiratory disease|respiratory illness]]. It is caused by an emerging [[coronavirus]], specifically a ''betacoronavirus'' called [[Middle east respiratory syndrome coronavirus|MERS-CoV]] ([[Middle east respiratory syndrome coronavirus|Middle East Respiratory Syndrome Coronavirus]]), first discovered in 2012. Being a relatively novel [[virus]], there is no [[virus]]-specific [[prevention]] or treatment options for [[MERS]] patients. Attending to the fact that a [[vaccine]] hasn't been developed yet, enhancing [[infection]] prevention and control measures is critical to prevent the possible spread of [[MERS-CoV]] in hospitals and communities. Persons with [[symptoms]] suspicious of [[MERS-CoV]] [[infection]] need medical evaluation. According to the [[CDC]], a ''confirmed case'' of [[MERS-CoV]] [[infection]] is considered an individual who shows laboratory confirmation of [[infection]] by [[MERS-CoV]]. This last one is given by a positive [[PCR]] test of ≥2 specific [[genomic]] targets or, a single positive target followed by successful [[sequencing]] of a second. On the contrary, a ''probable case'' of [[MERS-CoV]] [[infection]], is considered an individual under investigation who has missing or inconclusive laboratory test results for the [[infection]] and that has been in close contact with another individual who is a "laboratory-confirmed case" of [[MERS-CoV]] [[infection]].<ref name="pmid24841273">{{cite journal| author=Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J et al.| title=Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection. | journal=Antimicrob Agents Chemother | year= 2014 | volume= | issue= | pages= | pmid=24841273 | doi=10.1128/AAC.03036-14 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24841273  }} </ref><ref name=WHO>{{cite web | title = Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do | url = http://www.who.int/csr/disease/coronavirus_infections/InterimGuidance_ClinicalManagement_NovelCoronavirus_11Feb13u.pdf }}</ref><ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref><ref name=CDC case definitions>{{cite web | title = Middle East Respiratory Syndrome (MERS) | url = http://www.cdc.gov/coronavirus/mers/case-def.html }}</ref>
On chest CT-scan, patients with MERS-CoV may demonstrate changes similar to patients with [[ARDS]]. CT scan may demonstrate bilateral airspace abnormalities with ground glass opacities, predominantly located at the bases of the lungs, suggestive of organizing [[pneumonia]].<ref name="AjlanAhyad2014">{{cite journal|last1=Ajlan|first1=Amr M.|last2=Ahyad|first2=Rayan A.|last3=Jamjoom|first3=Lamia Ghazi|last4=Alharthy|first4=Ahmed|last5=Madani|first5=Tariq A.|title=Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: Chest CT Findings|journal=American Journal of Roentgenology|year=2014|pages=1–6|issn=0361-803X|doi=10.2214/AJR.14.13021}}</ref>


==CT==
==CT==
Despite the increasing number of publications on [[MERS]] [[infection]], the description of [[chest]] [[CT|CT image]] findings is scarce. In [[MERS]] patients, [[chest]] [[CT|CT images]] have shown bilateral patchy opacities, also described as extensive opacities. In critically ill patients, [[CT|CT image]] findings were noticed to be compatible with the ones from [[ARDS]] patients.<ref name="AjlanAhyad2014">{{cite journal|last1=Ajlan|first1=Amr M.|last2=Ahyad|first2=Rayan A.|last3=Jamjoom|first3=Lamia Ghazi|last4=Alharthy|first4=Ahmed|last5=Madani|first5=Tariq A.|title=Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: Chest CT Findings|journal=American Journal of Roentgenology|year=2014|pages=1–6|issn=0361-803X|doi=10.2214/AJR.14.13021}}</ref><ref name="AssiriAl-Tawfiq2013">{{cite journal|last1=Assiri|first1=Abdullah|last2=Al-Tawfiq|first2=Jaffar A|last3=Al-Rabeeah|first3=Abdullah A|last4=Al-Rabiah|first4=Fahad A|last5=Al-Hajjar|first5=Sami|last6=Al-Barrak|first6=Ali|last7=Flemban|first7=Hesham|last8=Al-Nassir|first8=Wafa N|last9=Balkhy|first9=Hanan H|last10=Al-Hakeem|first10=Rafat F|last11=Makhdoom|first11=Hatem Q|last12=Zumla|first12=Alimuddin I|last13=Memish|first13=Ziad A|title=Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study|journal=The Lancet Infectious Diseases|volume=13|issue=9|year=2013|pages=752–761|issn=14733099|doi=10.1016/S1473-3099(13)70204-4}}</ref><ref name="ArabiArifi2014">{{cite journal|last1=Arabi|first1=Yaseen M.|last2=Arifi|first2=Ahmed A.|last3=Balkhy|first3=Hanan H.|last4=Najm|first4=Hani|last5=Aldawood|first5=Abdulaziz S.|last6=Ghabashi|first6=Alaa|last7=Hawa|first7=Hassan|last8=Alothman|first8=Adel|last9=Khaldi|first9=Abdulaziz|last10=Al Raiy|first10=Basel|title=Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection|journal=Annals of Internal Medicine|volume=160|issue=6|year=2014|pages=389-397|issn=0003-4819|doi=10.7326/M13-2486}}</ref>
Chest CT abnormalities among patients with MERS-CoV may include any of the following:
*Extensive bilateral patchy opacities, predominantly in the lung bases and in the subpleural regions<ref name="AjlanAhyad2014">{{cite journal|last1=Ajlan|first1=Amr M.|last2=Ahyad|first2=Rayan A.|last3=Jamjoom|first3=Lamia Ghazi|last4=Alharthy|first4=Ahmed|last5=Madani|first5=Tariq A.|title=Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: Chest CT Findings|journal=American Journal of Roentgenology|year=2014|pages=1–6|issn=0361-803X|doi=10.2214/AJR.14.13021}}</ref><ref name="pmid15229349">{{cite journal| author=Ujita M, Renzoni EA, Veeraraghavan S, Wells AU, Hansell DM| title=Organizing pneumonia: perilobular pattern at thin-section CT. | journal=Radiology | year= 2004 | volume= 232 | issue= 3 | pages= 757-61 | pmid=15229349 | doi=10.1148/radiol.2323031059 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15229349  }} </ref><ref name="TravisCostabel2013">{{cite journal|last1=Travis|first1=William D.|last2=Costabel|first2=Ulrich|last3=Hansell|first3=David M.|last4=King|first4=Talmadge E.|last5=Lynch|first5=David A.|last6=Nicholson|first6=Andrew G.|last7=Ryerson|first7=Christopher J.|last8=Ryu|first8=Jay H.|last9=Selman|first9=Moisés|last10=Wells|first10=Athol U.|last11=Behr|first11=Jurgen|last12=Bouros|first12=Demosthenes|last13=Brown|first13=Kevin K.|last14=Colby|first14=Thomas V.|last15=Collard|first15=Harold R.|last16=Cordeiro|first16=Carlos Robalo|last17=Cottin|first17=Vincent|last18=Crestani|first18=Bruno|last19=Drent|first19=Marjolein|last20=Dudden|first20=Rosalind F.|last21=Egan|first21=Jim|last22=Flaherty|first22=Kevin|last23=Hogaboam|first23=Cory|last24=Inoue|first24=Yoshikazu|last25=Johkoh|first25=Takeshi|last26=Kim|first26=Dong Soon|last27=Kitaichi|first27=Masanori|last28=Loyd|first28=James|last29=Martinez|first29=Fernando J.|last30=Myers|first30=Jeffrey|last31=Protzko|first31=Shandra|last32=Raghu|first32=Ganesh|last33=Richeldi|first33=Luca|last34=Sverzellati|first34=Nicola|last35=Swigris|first35=Jeffrey|last36=Valeyre|first36=Dominique|title=An Official American Thoracic Society/European Respiratory Society Statement: Update of the International Multidisciplinary Classification of the Idiopathic Interstitial Pneumonias|journal=American Journal of Respiratory and Critical Care Medicine|volume=188|issue=6|year=2013|pages=733–748|issn=1073-449X|doi=10.1164/rccm.201308-1483ST}}</ref>
*[[Pleural effusions]]
*[[septal]] thickening
*Peribronchovascular involvement
*Traction [[bronchiectasis]] and reticulation
*Evidence of architectural distortion


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[category:disease]]


[[category:disease]]
[[Category:Infectious disease]]
[[category:virology]]
[[category:virology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]

Latest revision as of 18:04, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

On chest CT-scan, patients with MERS-CoV may demonstrate changes similar to patients with ARDS. CT scan may demonstrate bilateral airspace abnormalities with ground glass opacities, predominantly located at the bases of the lungs, suggestive of organizing pneumonia.[1]

CT

Chest CT abnormalities among patients with MERS-CoV may include any of the following:

  • Extensive bilateral patchy opacities, predominantly in the lung bases and in the subpleural regions[1][2][3]
  • Pleural effusions
  • septal thickening
  • Peribronchovascular involvement
  • Traction bronchiectasis and reticulation
  • Evidence of architectural distortion

References

  1. ↑ 1.0 1.1 Ajlan, Amr M.; Ahyad, Rayan A.; Jamjoom, Lamia Ghazi; Alharthy, Ahmed; Madani, Tariq A. (2014). "Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: Chest CT Findings". American Journal of Roentgenology: 1–6. doi:10.2214/AJR.14.13021. ISSN 0361-803X.
  2. ↑ Ujita M, Renzoni EA, Veeraraghavan S, Wells AU, Hansell DM (2004). "Organizing pneumonia: perilobular pattern at thin-section CT". Radiology. 232 (3): 757–61. doi:10.1148/radiol.2323031059. PMID 15229349.
  3. ↑ Travis, William D.; Costabel, Ulrich; Hansell, David M.; King, Talmadge E.; Lynch, David A.; Nicholson, Andrew G.; Ryerson, Christopher J.; Ryu, Jay H.; Selman, Moisés; Wells, Athol U.; Behr, Jurgen; Bouros, Demosthenes; Brown, Kevin K.; Colby, Thomas V.; Collard, Harold R.; Cordeiro, Carlos Robalo; Cottin, Vincent; Crestani, Bruno; Drent, Marjolein; Dudden, Rosalind F.; Egan, Jim; Flaherty, Kevin; Hogaboam, Cory; Inoue, Yoshikazu; Johkoh, Takeshi; Kim, Dong Soon; Kitaichi, Masanori; Loyd, James; Martinez, Fernando J.; Myers, Jeffrey; Protzko, Shandra; Raghu, Ganesh; Richeldi, Luca; Sverzellati, Nicola; Swigris, Jeffrey; Valeyre, Dominique (2013). "An Official American Thoracic Society/European Respiratory Society Statement: Update of the International Multidisciplinary Classification of the Idiopathic Interstitial Pneumonias". American Journal of Respiratory and Critical Care Medicine. 188 (6): 733–748. doi:10.1164/rccm.201308-1483ST. ISSN 1073-449X.
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