Measles Symptoms and Pathognomonic Signs

Measles Infection

• Generalized lymphadenopathy may occur in severe cases, particularly affecting cervical and occipital lymph nodes.
• In individuals with passively acquired antibody (e.g., infants, recipients of blood products), a subclinical form of measles may occur, characterized by:
  • Indistinct, brief, or absent rash
  • Mild or absent symptoms
• Modified measles is not highly contagious.

Laboratory Findings

• Diagnosis of measles is primarily based on clinical and epidemiologic findings.
• Laboratory findings during the acute phase include:
  • Reduced total white blood cell count
  • Decreased lymphocytes relative to neutrophils
  • Possibly absolute neutropenia
  • Normal erythrocyte sedimentation rate and C-reactive protein level in uncomplicated cases

Diagnosis and Confirmation

• Serologic confirmation is often recommended, especially in the absence of a recognized measles outbreak.
• Identification of IgM antibody in serum is a key diagnostic marker.
• IgM antibody appears 1-2 days after the onset of the rash and remains detectable for approximately 1 month.

Treatment and Management

• Management of measles is supportive, with no specific antiviral therapy approved.
• Goals of therapy include:
  • Maintenance of hydration
  • Oxygenation
  • Comfort
• Antipyretics are useful for comfort and fever control.
• Additional supportive measures may be necessary for patients with respiratory tract involvement.
• Vitamin A therapy is indicated for all patients with measles, with specific dosing regimens for different age groups.

Vaccination and Prevention

• Vaccination against measles is the most effective and safe prevention strategy.
• Measles vaccine is often combined with measles-mumps-rubella (MMR) vaccine.

Measles Characteristics

• Measles is a serious infection characterized by:
  • High fever
  • An enanthem
  • Cough
  • Coryza
  • Conjunctivitis
  • A prominent exanthem
• Incubation period is 8-12 days.
• Prodromal phase begins with a mild fever, followed by the onset of conjunctivitis, coryza, cough, and increasing fever.
• Koplik spots are a pathognomonic sign of measles, appearing 1-4 days prior to the onset of the rash.
• Rash begins on the forehead, behind the ears, and on the upper neck, then spreads downward to the torso and extremities.
• The exanthem frequently becomes confluent on the face and upper trunk.

Test your knowledge on the symptoms and pathognomonic signs of measles, including enanthem, cough, coryza, conjunctivitis, and Koplik spots. Learn about the prodromal phase, incubation period, and characteristic features of measles.