Measles in adults in often less serious than measles in a child. However, an adult may develop severe measles even if they have received a measles vaccine or had measles as a child.
Clinical features:
(1) nonprogressive cough early, with progression to respiratory failure and the need for mechanical ventilation
(2) fever
(3) morbilliform rash
(4) conjunctivitis
(5) hepatitis
(6) myositis
(7) improvement with intravenous ribavirin therapy
Laboratory findings:
(1) severe hypoxemia
(2) elevated serum CK
(3) thrombocytopenia
(4) hypocalcemia
Laboratory diagnosis of measles requires that at least one of the following be present:
(1) four-fold or greater rise in antibodies to measles
(2) isolation of the virus in culture
(3) demonstration of the virus by molecular technique
Complications:
(1) multi-organ failure
(2) bacterial pneumonia
The patient workup should include:
(1) an evaluation of vaccination status and history of previous measles infection. If previously vaccinated, then the type of vaccine should be determined.
(2) identification of possible risk factors (immunodeficiency, cancer chemotherapy, etc)
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