In fact, in the medical field, the name of this infectious disease that occurred in 2003 is controversial, because it has been found out that this disease is actually not "atypical pneumonia" that is often said in medicine, but "infectious coronavirus pneumonia".
For this kind of infectious diseases, people's understanding has gradually deepened and their concepts have gradually become correct. At first, chlamydia virus was thought to be the cause of the disease, but it was not until March 2003 that the pathogen was considered as a "coronavirus". Doctors in Guangdong, China first used "atypical pneumonia" on June 22nd, 65438. According to its clinical symptoms, such as fever, cough and shadow in the lungs. However, compared with pneumonia caused by Streptococcus pneumoniae and other bacteria, the symptoms are atypical, the pathogen is not completely clear, and it is highly contagious, so the use of antibacterial drugs is ineffective. The World Health Organization also confirmed its drug. At the end of February, Dr. carlo urbani, an Italian infectious disease expert of the World Health Organization, named it Severe Acute Respiratory Syndrome (SARS) according to the data at that time. On March 15, the World Health Organization officially replaced ATP with it.
In fact, the name of severe acute respiratory syndrome does not fully reflect the essential characteristics of the disease. It has long been suggested to name it "infectious coronavirus pneumonia" (if so, it can be called "coronary lung" for short). Although this suggestion has not been accepted by the society and medical circles, it is enough to prove that SARS, like SARS, reflects people's understanding of the distinctive characteristics of things at a certain stage.
A cure has been found so far. Scientists from China and the European Union have jointly found 15 compounds which can effectively kill SARS virus, providing a new method for synthesizing SARS therapeutic drugs. On June 9th, 2005, scientists from China and Europe announced this achievement at the annual conference of "Diagnosis and Virus Research of SARS in China and Europe" which ended in Hangzhou.
Recent research by the University of Hong Kong shows that bats may be the wild hosts of SARS virus.
Zhou Gang, an expert in computer Chinese character input, proposed in 2003 that "atypical pneumonia" can be called "tuberculosis".
However, it is still suggested to call it SARS in the medical field according to the naming principle of the World Health Organization (WHO). Like WHO, the Hong Kong medical community changed its name to SARS and Chinese mainland at the first time. Because people have always referred to it as "SARS", it is not recommended to change the entry itself.
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In traditional medicine, atypical pneumonia is relative to typical pneumonia, which is usually caused by common bacteria such as pneumococcus. Typical symptoms, such as fever, chest pain, cough and expectoration. Laboratory tests show that white blood cells increase and antibiotic treatment is effective. Atypical pneumonia itself is not a newly discovered disease, it is mostly caused by viruses, mycoplasma, chlamydia, rickettsia and other pathogens. Symptoms, lung signs and blood test results are not as obvious as SARS infection, and some viral pneumonia antibiotics are ineffective.
SARS refers to a group of diseases caused by the above atypical pathogens, not a definite diagnosis. Its clinical characteristics are that the onset is hidden, mostly dry cough, occasional hemoptysis, and less positive signs of auscultation in the lungs; X-ray chest film mainly shows interstitial infiltration; Its pathogenesis is usually mild, and patients rarely die because of it.
The name of atypical pneumonia originated at the end of 1930, which corresponds to typical pneumonia, mainly lobar pneumonia or bronchopneumonia caused by bacteria. In 1960s, Mycoplasma pneumoniae was considered as the main pathogen of atypical pneumonia, but other pathogens were later discovered, especially Chlamydia pneumoniae. At present, it is believed that the main pathogens of atypical pneumonia are mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Legionella and Rickettsia (causing Q fever pneumonia), especially the first two, which account for almost 1/3 of hospitalized adults with community-acquired pneumonia every year. Most of these pathogens are intracellular parasites without cell walls, so broad-spectrum antibiotics (mainly macrolides and tetracyclines) that can penetrate into cells are effective for their treatment, while β -lactams are ineffective. Antibiotics are ineffective for SARS caused by virus.
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Huang Xingchu, the first SARS patient reported in China (commonly known as "SARS patient" in Chinese mainland), is also the first case in the world.
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Clinical diagnosis of symptoms and signs of SARS
1. Epidemiological history
1. 1 had close contact with similar patients two weeks before onset or had clear evidence of infecting others.
1.2 lived in epidemic area or SARS epidemic area 2 weeks before onset.
2. Symptoms and signs
Fever (> 38℃), cough, rapid breathing, shortness of breath, or respiratory distress syndrome, lung rales or more than one sign of lung consolidation.
3. Laboratory inspection
Early white blood cell count does not increase or decrease.
4. Lung imaging examination
Patchy and patchy infiltrative shadows or reticular changes in the lung to varying degrees.
5. The effect of antibacterial drugs is not obvious.
Clinical diagnosis of SARS
According to the comprehensive judgment of epidemiological data, symptoms and signs, laboratory examination and pulmonary imaging examination, the clinical diagnosis was made. Once the pathogen is identified and the detection method is specific, the definition of confirmed cases is established.
Suspected cases: 1. 1+2+3 or 1.2+2+3+4.
Clinically diagnosed cases: 1. 1+2+3+4 or 1.2+2+3+4+5.
Diagnostic criteria for severe acute respiratory syndrome cases
SARS cases meet the following criteria, among which 1 can be diagnosed as severe SARS cases:
1. Multi-leaf lesion or X-ray chest film progress within 48 hours >: 50%
2. dyspnea, respiratory frequency >; 30 times/minute;
3. In hypoxemia, when the oxygen uptake is 3-5 liters/minute, Sao 2
4. Shock, ARDS or MODS (multiple organ dysfunction syndrome) occurs.
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Obviously, because SARS is caused by virus, any antibiotic drugs that are effective for bacteria have no obvious effect on this disease.
Traditional "atypical pneumonia" may be caused by pathogens such as mycoplasma, chlamydia, rickettsia, or rare bacteria, so it may be sensitive to macrolide antibiotics, that is, macrolide antibiotics (erythromycin) can be used as specific drugs.
But if "atypical pneumonia" in the traditional sense is also caused by viruses, antibiotics are also ineffective. At this point, if you use antibiotics, it is actually abusing antibiotics.