Measles associated pneumonia and hepatitis during the measles outbreak of 2018.
Int J Clin Pract. 2019 Oct 01;:e13430
Authors: Kakoullis L, Sampsonas F, Giannopoulou E, Kalogeropoulou C, Papachristodoulou E, Tsiamita M, Lykouras D, Velissaris D, Karkoulias K, Spiropoulos K, Panos G
Abstract
BACKGROUND: Between 2017 and 2018, Greece experienced a measles outbreak, affecting >3000 patients, most of which were unvaccinated. Measles associated pneumonia (MAP) is the most common serious compilation of the disease, but very few recent reports regarding its presentation are available.
MATERIALS AND METHODS: Between January and May of 2018 eleven adult patients presented to our department with acute measles virus infection, hypoxia and findings on chest x-ray. Clinical, laboratory and radiological data were collected and assessed. Nine out of eleven patients had hypoxic respiratory failure. Other complications included hepatitis, cholestasis and myositis, which were observed in the majority of patients. All patients received supplementary oxygen administration, while five patients required continuous positive airway pressure ventilation. Scoring of the radiological examinations performed was most notable for the presence of reticular opacities and consolidations. Statistical analysis demonstrated a significant association between PO2/FiO2 values and the presence of reticular opacities, with PO2/FiO2 decreasing as the mean value of the reticular opacities score increased (p = 0.02).
CONCLUSION: To our knowledge, this is the first report demonstrating an association between PO2/FiO2 values and the presence of reticular opacities in patients with MAP. MAP should be suspected in any patient presenting with acute onset hypoxemia and a reticular pattern on radiological examination, especially in outbreak settings.
PMID: 31573732 [PubMed - as supplied by publisher]