[Measles pneumonia presenting with multiple nodular opacities on chest radiographs]

A 22-year-old woman presented with fever, cough, and maculopapular erythematous rash on hands and feet. These symptoms developed 14 days after the onset of natural measles in the patient's daughter. Chest radiographs obtained on the first examination showed multiple nodular opacities and infiltrates in the left and right lung fields. Serological examinations disclosed elevated levels of the specific IgM antibody and a remarkably elevated hemagglutination inhibition (HI) titer, indicating a recent measles infection. The patient's symptoms, skin eruptions, and abnormal chest radiograph findings disappeared after several days. However, chest computed tomographic scans taken 8 months after the initial examination revealed small, residual nodular opacities. Other than the fact that the patient had received attenuated measles virus vaccine, these findings were typical of the clinical course for atypical pneumonia. We concluded that in the differential diagnosis of multiple nodular opacities on chest radiographs, adequate attention should be given to pulmonary involvement of measles infection.