Some patients present with typical measles while others may have an atypical presentation.
Severe pneumonia is more likely to affect a patient who is immunodeficient or immunosuppressed.
While most patients with measles pneumonia have no history of prior measles or measles vaccination, it can occur in patients who have had the measles vaccine.
Clinical findings may include:
(1) dyspnea
(2) cough
(3) fever
(4) hypoxemia
(5) cervical lymphadenopathy
Chest imaging shows a diffuse micronodules and ground glass opacities unless secondary bacterial pneumonia develops.
Lung biopsy may show an interstitial pneumonia with multinucleated giant cells.
A secondary bacterial infection may occur.
Diagnosis:
(1) rise in measles antibody titers
(2) presence of multi-nucleated giant cells with intranuclear or intracytoplasmic inclusions (can also occur in infections with parainfluenza type 3)
(3) molecular studies (RT-PCR)
