brazjinfectdis2020;24(3):266–267
w w w . e l s e v ie r . c o m / l o c a t e / b j i d
The Brazilian Journal of
INFECTIOUS DISEASES
Clinical image
Pulmonary involvement in patients with measles
Bruno Hochhegger
a, Gláucia Zanetti
b, Edson Marchiori
b,∗aPontifíciaUniversidadeCatólicadoRioGrandedoSul,ProgramadePós-Graduac¸ãoemMedicina,PortoAlegre,RS,Brazil
bUniversidadeFederaldoRiodeJaneiro,RiodeJaneiro,RJ,Brazil
a r t i c l e i n f o
Articlehistory:
Received17February2020 Accepted21March2020 Availableonline10April2020
A55-year-oldmalepresentedwitha4-day historyoffever, cough, and coryza. One day later, a maculopapular rash appeared,primarilyonthefaceandsubsequentlyspreading.
He sought medical attention and was admitted for inves- tigation. At that time, Koplik’s spots were also identified.
Computed tomographyofthe chest showed consolidations andground-glassopacitiesinbothlungs(Fig.1).Adiagnosisof measleswasmadeaftermeaslesvirus-specificimmunoglob- ulinMantibodiesweredetectedinserumandtheviruswas detectedbyreal-timepolymerasechainreaction.Thepatient improvedandwasdischargedonthesixthdayafteradmis- sion.
Inrecentyears,therehavebeenseveralmeaslesoutbreaks, not only in children but also in adults, with serious and occasionallyfatalcomplications.Many countries areinthe midstofmajoroutbreaks ofthe disease,all regionsofthe worldexperiencingan increaseinthe number ofcases.In 2019,approximately61,000suspectedcasesofmeasleswere
∗ Correspondingauthor.
E-mailaddress:[email protected](E.Marchiori).
reportedinBrazil,approximately16,000ofwhichwerecon- firmed,eitherbylaboratorytestsoronthebasisofclinical andepidemiologicalcriteria.Mostofthecasesoccurredinthe statesofSãoPaulo,MinasGerais,Paraná, Pernambuco,and RiodeJaneiro.1
Most measles-related deaths are due to complications.
Commoncomplicationsincludepneumonia,severediarrhea, otitis, and keratoconjunctivitis, which is a leading cause of blindness. Complicationsof measles are more common in childrenunderfive years ofagewho are malnourished, in adults over 20 years of age, in pregnant women, and inimmunocompromisedindividuals.Pneumoniaisamajor causeofmorbidityandmortalityinmeaslespatients,being causedbythevirusitselforbysecondarybacterialinfection.2,3 The imagingfindings are nonspecific, potentially including consolidationsorground-glassopacitieswithalobularorseg- mentaldistribution,thickeningofthebronchial/bronchiolar walls,nodules,andsmallcentrilobularnodules.4
https://doi.org/10.1016/j.bjid.2020.03.004
1413-8670/©2020SociedadeBrasileiradeInfectologia.PublishedbyElsevierEspa ˜na,S.L.U.ThisisanopenaccessarticleundertheCC BY-NC-NDlicense(http://creativecommons.org/licenses/by-nc-nd/4.0/).
brazj infect dis.2020;24(3):266–267
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Fig.1–Computedtomographyofthechest.Axialslices(AandB)andcoronalslices(CandD)showingmultiplefociof consolidationandground-glassopacitiesinbothlungs.Thereisnoevidenceoflymphnodeenlargementorpleuraleffusion.
Conflict of interest
Theauthorsdeclarenoconflictsofinterest.
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