Atypical measles in adolescents: evaluation of clinical and
pulmonary function.
Hall WJ, Hall CB.
During a community outbreak of measles, 10 patients aged 11 through 19 were
hospitalized with prominent pulmonary infiltrates and clinical manifestations of
high fever and rash. Diagnoses of atypical measles were confirmed by
hemagglutination-inhibition and complement-fixation antibody studies. Patients
were followed with pulmonary function studies for 12 weeks. The most common
admitting diagnoses were varicella, scarlet fever, meningococcemia, and Rocky
Mountain spotted fever, due largely to the protean cutaneous manifestations.
Roentgenographic studies showed diffuse, segmental, and nodular chest lesions.
Hypoxemia (mean arterial Po2, 58 mm Hg) and markedly reduced lung volumes were
noted. Gradual resolution of physiologic abnormalities was noted during 12
weeks, but two children had persistent nodular densities seen on chest
roentgenograms. Atypical measles in the older child and young adult has a wide
spectrum of pulmonary manifestations ranging from acute respiratory failure to
isolated nodular lesions. Proper recognition of this syndrome will prevent
unnecessary invasive diagnostic procedures.
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