What are the clinical manifestations of Measles virus pneumonia?

Updated: Mar 24, 2021
  • Author: Zab Mosenifar, MD, FACP, FCCP; Chief Editor: John J Oppenheimer, MD  more...
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The incubation period of measles is 10-14 days after exposure, after which a prodrome of fever, malaise, anorexia, conjunctivitis, cough, and coryza ensue. Toward the end of the prodrome, Koplik spots (small white punctate lesions) may appear on the buccal mucosa.

The rash is an erythematous, maculopapular eruption that may become confluent, beginning on the face, then progressing down the body to involve the extremities last, including palms and soles.

Atypical measles occurs in patients who were immunized from 1963-1967 with a killed vaccine and are exposed to measles virus or live measles virus vaccine. In these cases, the rash starts in the hands and feet rather than in a central distribution.

Duration of the rash is approximately 5 days, after which it may desquamate. Duration of symptoms is usually 10 days, and the cough may be the last symptom to disappear.

In adults, 3% of measles cases are complicated by significant pneumonia requiring hospitalization, with 17% of patients experiencing bronchospasm and 30%, bacterial superinfection. Bacterial superinfection most often occurs 5-10 days after the onset of the rash. The pulmonary findings parallel the cutaneous signs, and the severity of pneumonia correlates with worsening rash.

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