open access
Measles pneumonitis
open access
Abstract
Measles is an acute febrile illness, potentially fatal and highly contagious, which is transmitted through the respiratory mode. Fever
combined with one of the following: cough, coryza, conjunctivitis are the first manifestations of the disease. Koplik’s spots may
also appear on the buccal mucosa providing an opportunity to set the diagnosis even before the emergence of rash. Rash typically
appears 3–4 days after the onset of fever, initially on the face and behind the ears, and its appearance is associated with the peak
of the symptoms. Measles affects multiple systems, including the respiratory system, with pneumonia being one of the most lethal
complications. Management involves best supportive care, correction of dehydration and nutritional deficiencies, treatment of
secondary bacterial infections and provision of vitamin A. Importantly, given that measles present with lifelong immunity following
infection or vaccination, prevention through measles vaccination has a cardinal role for measles’ elimination. Indeed, public education
and vaccination led to an estimated 79% decrease in global measles deaths from 2000 to 2015. Nonetheless, the last two years have
seen a measles outbreak in several countries, partially due to the anti-vaccination movement. This article aims to present two cases
of measles in our hospital and highlight the pressing need for vaccination in order to eradicate a potentially fatal disease.
Abstract
Measles is an acute febrile illness, potentially fatal and highly contagious, which is transmitted through the respiratory mode. Fever
combined with one of the following: cough, coryza, conjunctivitis are the first manifestations of the disease. Koplik’s spots may
also appear on the buccal mucosa providing an opportunity to set the diagnosis even before the emergence of rash. Rash typically
appears 3–4 days after the onset of fever, initially on the face and behind the ears, and its appearance is associated with the peak
of the symptoms. Measles affects multiple systems, including the respiratory system, with pneumonia being one of the most lethal
complications. Management involves best supportive care, correction of dehydration and nutritional deficiencies, treatment of
secondary bacterial infections and provision of vitamin A. Importantly, given that measles present with lifelong immunity following
infection or vaccination, prevention through measles vaccination has a cardinal role for measles’ elimination. Indeed, public education
and vaccination led to an estimated 79% decrease in global measles deaths from 2000 to 2015. Nonetheless, the last two years have
seen a measles outbreak in several countries, partially due to the anti-vaccination movement. This article aims to present two cases
of measles in our hospital and highlight the pressing need for vaccination in order to eradicate a potentially fatal disease.
Keywords
measles, Koplik’s spots, rash, vaccination
About this articleTitle
Measles pneumonitis
Journal
Advances in Respiratory Medicine
Issue
Article type
Case report
Pages
63-67
Published online
2019-03-04
DOI
10.5603/ARM.a2019.0010
Pubmed
Bibliographic record
Adv Respir Med 2019;87(1):63-67.
Keywords
measles
Koplik’s spots
rash
vaccination
Authors
Pinelopi Schoini
Theodoros Karampitsakos
Maria Avdikou
Aggeliki Athanasopoulou
Georgios Tsoukalas
Argyrios Tzouvelekis
References (15)- Moss WJ, Graham M. Measles. Lancet. 2017; 390: 2490–2502.
- Hope K, Boyd R, Conaty S, et al. Measles transmission in health care waiting rooms: implications for public health response. Western Pac Surveill Response J. 2012; 3(4): 33–38.
- Rota PA, Moss WJ, Takeda M, et al. Measles. Nature reviews Disease primers. 2016; 2: 16049.
- Bassetti M, Schenone E, Calzi A, et al. Measles outbreak in adults in Italy. Infez Med. 2011; 19(1): 16–19.
- Lindberg C, Lanzi M, Lindberg K. Measles: Still a Significant Health Threat. MCN Am J Matern Child Nurs. 2015; 40(5): 298–305; quiz E21.
- Premaratna R, Luke N, Perera H, et al. Sporadic cases of adult measles: a research article. BMC Res Notes. 2017; 10(1): 38.
- Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis. 2004; 189 Suppl 1: S4–16.
- Cherry J, Heininger U. Measles Morbidity and Mortality in the Developed World are Greater than the Public Perceives. Open Forum Infectious Diseases. 2017; 4(suppl_1): S574–S574.
- Ortac Ersoy E, Tanriover MD, Ocal S, et al. Severe measles pneumonia in adults with respiratory failure: role of ribavirin and high-dose vitamin A. Clin Respir J. 2016; 10(5): 673–675.
- Scavone C, Sessa M, Clementi E, et al. Italian Immunization Goals: A Political or Scientific Heated Debate? Front Pharmacol. 2018; 9: 574.
- Suter C, Buergi U, Eigenmann K, et al. Severe acute measles pneumonitis: virus isolation in bronchoalveolar lavage fluid. BMJ Case Rep. 2015; 2015.
- Benamar T, Tajounte L, Alla A, et al. Real-time PCR for measles virus detection on clinical specimens with negative IgM result in morocco. PLoS One. 2016; 11(1): e0147154.
- Abad CL, Safdar N. The Reemergence of Measles. Curr Infect Dis Rep. 2015; 17(12): 51.
- https://www.cdc.gov/vaccines/vpd/mmr/public/index.html.
- Jain A, Marshall J, Buikema A, et al. Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. JAMA. 2015; 313(15): 1534–1540.