Measles

Photo) Measles virus infect and affect the morphology of cells in culture.

----Linda Stannard, Department of Medical Microbiology, University of Cape Town

　 　

➞ Case presentation( 4 year old boy)

Clinical course of Measles(4-year-old boy):

Days 2; fever with cough and runny nose.

----------Antibiotics and anti-cough drugs were prescribed.

late of Days 3; Koplik's spot appeared in buccal mucosa.

Days 4: many Koplik's spot

---------late of Days 4; maculopapular rash began from face.

Days 5; skin rash spread to upper limb and trunk,

----------descending to lower parts.

----------WBC 7,000(39% Lym, 9% Mon, 45% Seg, 7% Band),

----------CRP 0.43mg/dl.

Days 6; peak of skin rash.

Days 8; fever fall down.

----------WBC 5,900(Atypical cell 36%, Lym44%, Mon2%,

-----------Band5%, Seg9%, Eos4%)

Days 9; no fever. skin pigmentation began.

Photo: Measles's rash

Koplik's spots: tiny white spot in buccal mucosa, look-like" thrush"

----------

Measles

----------

Symptoms:

----------After high fever lasting 3-4 days with dry cough ,

----------sometimes croup and blear eye, Koplik's spot appear

----------on buccal mucosa( may also conjunctivae or rectum).

------------Within 1-2 day, the red maculopapular rash begins

----------behind the ears and spread to the face. the rash spreads

----------down the body, taking 2-3 days to progress to the lower

----------limb. About the time the rash appears on the chest, the

----------dry cough moistens, and occasionally fine crackles may

----------be heard in the lung(measles bronchitis).

Etiology: Measles virus (RNA virus, paramyxovirus family)

Incubation period: 8-12 days

Transmission route:

------------direct contact with patient, via coughing and sneezing.

------------Patient can be transmitted virus from 4 days prior to

------------the onset of rash to 4 days after the onset of disease.

-----------    Virus can stay in the air up to 75minutes after a known

-------------case of measles has left the room.

Complications:

1) Otitis media

2) Broncho-pneumonia: often infant and toddler, bacterial

3) febrile convulsion: infant and toddlers

4) Laryngo-tracheo-bronchitis:

5) Meningo(-encephalo-)myelitis: appear in convalescent stage

6) Encephalitis: appear 4-5 days after the onset of rash.

7) SSPE: very rare

8) kelatitis: in vitamin-A deficiency countries.

Any questions: write to Keiji Hagiwara MD,

keijihagiwara@gmail.com