Signs and symptoms

Initial symptoms are flu-like and may include fever, myalgia, lethargy symptoms, cough, sore throat, and other nonspecific symptoms. The only symptom common to all patients appears to be a fever above 38 °C (100 °F). SARS may eventually lead to shortness of breath and/or pneumonia; either direct viral pneumonia or first bacterial pneumonia.

Diagnosis

A chest X-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS

SARS may be suspected in a patient who has:

• Any of the symptoms, including a fever of 38 °C (100 °F) or higher, and
• Either a history of:

1. Contact (sexual or casual) with someone with a diagnosis of SARS within the last 10 days OR
2. Travel to any of the regions identified by the World Health Organization (WHO) as areas with recent local transmission of SARS (affected regions as of 10 May 2003 were parts of China, Hong Kong, Singapore and the town of Geraldton, Ontario, Canada).

For a case to be considered probable, a chest X-ray must be positive for atypical pneumonia or respiratory distress syndrome.
The World Health Organization (WHO) has added the category of "laboratory confirmed SARS" for patients who would otherwise be considered "probable" but who have not yet had a positive chest X-ray changes, but have tested positive for SARS based on one of the approved tests (ELISA, immunofluorescence or PCR).^[4]
When it comes to the chest X-ray the appearance of SARS is not always uniform but generally appears as an abnormality with patchy infiltrates.^[5]