Adult Measles â€“ Case Reports of a Highly Contagious Disease

AndrÃ© Koch; Claudia KrÃ¶nert; Torello Lotti; Aleksandra Vojvodic; Uwe Wollina

doi:10.3889/oamjms.2019.540

Authors

AndrÃ© Koch Department of Dermatology and Allergology, StÃ¤dtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
Claudia KrÃ¶nert Department of Dermatology and Allergology, StÃ¤dtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
Torello Lotti Department of Dermatology, University of Rome â€œG. Marconiâ€, Rome, Italy
Aleksandra Vojvodic Military Medical Academy of Belgrade, Belgrade, Serbia
Uwe Wollina Department of Dermatology and Allergology, StÃ¤dtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany

DOI:

https://doi.org/10.3889/oamjms.2019.540

Keywords:

Measles, Viral exanthema, Vaccination, Maculopapular rash, Encephalopathy, Thromboytopenia, Pneumonia

Abstract

BACKGROUND: Measles is highly contagious and is caused by the RNA morbillivirus. The best protection is active immunisation in early childhood. Without immunisation morbidity and mortality of measles are high. In recent years, an increasing number of adult measles has been recognised in Europe.

CASE REPORTS: We report here on two adult patients â€“ a 40-year-old male and a 55-year-old female â€“ who presented with fever, fatigue, cough, coryza, conjunctivitis and maculopapular rash. The suspicion of adult measles infection was confirmed by positivity for IgM antibodies against measles virus and reverse-transcriptase polymerase chain reaction in blood and urine. Patients were isolated, and the treatment was symptomatic. In the younger patient, complete recovery was achieved within two weeks. In the older patient, an acute encephalopathy developed after initial improvement characterised by cognitive impairment.

CONCLUSIONS: In patients presenting with fever and maculopapular rash and fatigue, measles should be considered even in adult patients. Early diagnosis with subsequent isolation and registration of patients are important measures to prevent local outbreaks of the disease.