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Middle East respiratory syndrome (MERS)

Last reviewed: 1 Nov 2024
Last updated: 22 Jun 2023

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
Full details

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
Full details

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
Full details

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
Full details

Tests to consider

  • serology
  • CT chest
Full details

Treatment algorithm

INITIAL

suspected MERS

ACUTE

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

Disclosures

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

Disclosures

WAP declares that he has no competing interests.

  • Middle East respiratory syndrome (MERS) images
  • Differentials

    • Coronavirus disease 2019 (COVID-19)
    • Severe acute respiratory syndrome (SARS)
    • Common cold
    More Differentials
  • Guidelines

    • CDC Yellow Book: health information for international travel - Middle East respiratory syndrome/MERS​
    • CDC Yellow Book: health information for international travel - Middle East respiratory syndrome/MERS
    More Guidelines
  • Calculators

    CURB-65 pneumonia severity score

    More Calculators
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