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1、Jpn.J.Infect.Dis.,69,361–366,2016OriginalArticleClinicalImplicationsof5CasesofMiddleEastRespiratorySyndromeCoronavirusInfectioninaSouthKoreanOutbreakJi-YoungRhee1*,GoohyeonHong2,andKyoungMinRyu31DivisionofInfectiousdiseases,DepartmentofMedicine;2DivisionofAllergyandPulmonaryMedicine,Depart
2、mentofInternalMedicine;and3DepartmentofThoracicandCardiovascularSurgery,DankookUniversityHospital,DankookUniversityCollegeofMedicine,Cheonan,SouthKoreaSUMMARY:TheKoreaMiddleEastrespiratorysyndromecoronavirus(MERS-CoV)wasfirstcon-firmedonMay20,2015,withasubsequentoutbreakinSouthKorea.Fivepa
3、tientswithsuspectedMERS-CoAinfectionwereadmittedtoourhospitalduringthisoutbreak.Onepatienthadnomajorsymptomsuponadmission,butpneumoniawasidentifieduponchestradiography.Twopatientsprogressedrapidlytoacuterespiratoryfailureandrequiredventilator-assistedrespiration.Onepatientrequiredextracorp
4、orealmembraneoxygenationtotreatrefractoryhypoxemia,andonepatientdiedofshockwithmultiorganfailure.Allthepatientshadfever,myalgia,leucopenia,normalprocalcitoninlevel,andpneumonia.Importantly,cliniciansshouldtestforpneumoniainallsuspectedpatientswithMERS-CoVinfection,evenintheabsenceofrespira
5、torysymptoms.Thepneumoniausuallyaffectedthelowerlobes.Ashorterincubationperiodwasassociatedwithmoreseverediseaseandgreaterriskofmortality,andtheseverityoffeverpredictedtheprognosisofMERS-CoVinfection-relatedpneumonia.Therefore,incasesoflower-lobepneumoniathatoccurduringanMERS-CoVoutbreakan
6、dareunes-ponsivetoantibiotics,cliniciansshouldconsiderthepossibilityofMERS-CoVinfection.developeddyspneaandcoughdeveloped,andhewasINTRODUCTIONtransferredvialocalClinicC(Yulineuwon)totheInSeptember2012,theMiddleEastrespiratorysyn-SamsungMedicalCenter(HospitalD).Thepossibilitydromecoronaviru
7、s(MERS-CoV)wasfirstreportedinofMERS-CoVinfectionwasfirstconsideredonMaySaudiArabia,in2patientswithseverepneumonia(1).18.Atthattime,thepatientwasisolatedandindividualThisviruscausessporadicinfections,aswellasin-precautionswereimplemented.MERS-CoVinfectiontrafam
