Summary
Definition
History and exam
Key diagnostic factors
- residence in, or travel to, the Middle East (or country where there is an active outbreak) in previous 14 days
- age >14 years
- fever
- cough
- dyspnea
Other diagnostic factors
- hemoptysis
- diarrhea
- abdominal pain
- nausea/vomiting
- chills/rigors
- myalgia
- arthralgia
- malaise
- headache
- sore throat
- rhinorrhea
- tachypnea
- tachycardia
- cyanosis
- chest pain
- crackles/rales on auscultation
Risk factors
- residence in, or travel to, the Middle East (or country where there is an active outbreak) in previous 14 days
- close contact with infected individuals
- exposure to infected dromedary camels
Diagnostic tests
1st tests to order
- CBC
- comprehensive metabolic panel
- pulse oximetry
- blood cultures
- real-time reverse transcription polymerase chain reaction (RT-PCR)
- RT-PCR sequencing assay
- chest x-ray
Tests to consider
- serology
- CT chest
Treatment algorithm
suspected MERS
confirmed MERS: post initial stabilization and isolation measures
Contributors
Authors
Sarah Shalhoub, MD
Infectious Diseases Consultant
London Health Sciences Center
Western University
London
Canada
Disclosures
SS is the author of several references cited in this topic.
Ali S. Omrani, MBBCh, MSc, FRCP, FRCPath
Senior Consultant, Infectious Diseases
Communicable Diseases Center
Hamad Medical Corporation
Doha
Qatar
Disclosures
ASO is the author of several references cited in this topic.
Peer reviewers
Ioannis P. Kioumis, MD, PhD
Associate Professor of Pulmonary Medicine and Infectious Diseases
Aristotle University of Thessaloniki
Respiratory Medicine Clinic
General Hospital G. Papanikolaou
Thessaloniki
Greece
利益声明
IPK declares that he has no competing interests.
William A. Petri, Jr, MD, PhD, FACP
Chief
Division of Infectious Diseases and International Health
University of Virginia
Charlottesville
VA
利益声明
WAP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013 Sep;13(9):752-61.全文 摘要
Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301-6.全文 摘要
Alraddadi BM, Watson JT, Almarashi A, et al. Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia, 2014. Emerg Infect Dis. 2016;22:49-55.全文 摘要
World Health Organization. Clinical management of severe acute respiratory infection when Middle East respiratory syndrome coronavirus (MERS-CoV) infection is suspected. Interim guidance. Jan 2019 [internet publication].全文
Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13-e22.全文 摘要
Arabi YM, Balkhy HH, Hayden FG, et al. Middle East respiratory syndrome. N Engl J Med. 2017 Feb 9;376(6):584-94.全文 摘要
Arabi YM, Asiri AY, Assiri AM, et al. Interferon beta-1b and lopinavir-ritonavir for Middle East respiratory syndrome. N Engl J Med. 2020 Oct 22;383(17):1645-56.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Coronavirus disease 2019 (COVID-19)
- Severe acute respiratory syndrome (SARS)
- Common cold
更多 鉴别诊断指南
- Laboratory testing for MERS
- Prevention and control for hospitalized MERS patients
更多 指南医学计算器
CURB-65 pneumonia severity score
更多 医学计算器登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明