Measles virus infection as an element of differential diagnosis with other viral diseases – case reports

1 Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
2 Students’ Scientific Society, Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland,
Correspondence: Agata Wawrzyniak, Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland, e-mail: awawrzyniak@wim.mil.pl

Pediatr Med Rodz 2020, 16 (1), p. 93–99
DOI: 10.15557/PiMR.2020.0016
ABSTRACT

Introduction: Measles is an infectious disease caused by an RNA virus of the genus Morbillivirus of the Paramyxoviridae family. It is most common in children up to the age of 15 years; however, the disease can occur at any age. The virus is transmitted through respiratory droplets. Measles presents with macular or maculopapular rash. It first appears on the head, and then spreads to the trunk and the limbs (descending nature). The rash fades in the same order it appeared, leaving skin discolourations. Measles complications occur in about 20–30% of patients, with most of them reported in children ≤5 years of age and adults >20 years of age. Diagnosis is based on the clinical picture confirmed by serology. According to the guidelines of the World Health Organization, each suspected case should be confirmed with laboratory testing (serological or molecular diagnosis). Active immunisation is the only effective method for preventing the spread of the measles virus. In Poland, measles vaccination is one of the free mandatory vaccinations. Complete clearance of the virus is seen in the majority of immunocompetent patients. There is no specific antiviral treatment for measles. Supportive care in the form of maintaining hydration and antipyretics is used. Antimicrobial treatment should be implemented only in the case of complications. Aim: The aim of this paper is to present cases of children who developed a macular rash suggestive of measles during respiratory infection. Conclusions: Measles is an infectious disease associated with high complication rates, especially in the youngest children. Detailed differential diagnosis is needed due to its similar clinical picture to those seen in other viral rash diseases.

Keywords: measles, MMR vaccine, infectious mononucleosis, macular rash, vitamin A