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Familial cases of severe measles pneumonia
1Department of Internal Medicine, Kurashiki Central Hospital.
Abstract:
We report two cases of severe measles pneumonia. Patient 1, a 17-year-old boy who contracted measles in the acute phase of infectious mononucleosis caused by Epstein-Barr virus (EBV), transmitted the disease to patient 2, his father. Both patients presented severe pneumonia with bilateral diffuse micronodular shadows. Diagnoses were established in both patients by antibody titers for measles and reverse transcriptase-polymerase chain reaction (RT-PCR) of blood and throat swab. Multinucleated giant cells with intranuclear inclusion bodies were revealed in the transbronchial lung biopsy (TBLB) specimen of patient 2. Both patients recovered with pulse steroid therapy.
Insights
Severe measles pneumonia occurred in a teen with infectious mononucleosis and his father. Both recovered with steroid therapy after diagnosis via antibody titers and RT-PCR testing.
Area of Science:
- Virology
- Pulmonology
- Immunology
Background:
- Measles can cause severe pneumonia, particularly in immunocompromised individuals.
- Epstein-Barr virus (EBV) is a common cause of infectious mononucleosis.
- Co-infection with measles and EBV can lead to complex clinical presentations.
Observation:
- Two cases of severe measles pneumonia are presented.
- Patient 1 contracted measles during acute Epstein-Barr virus (EBV) infectious mononucleosis.
- Patient 1 transmitted measles to Patient 2, his father, who also developed severe pneumonia.
Findings:
- Both patients exhibited bilateral diffuse micronodular lung shadows on imaging.
- Diagnosis was confirmed by measles antibody titers and RT-PCR of blood and throat swabs.
- Transbronchial lung biopsy (TBLB) in Patient 2 revealed characteristic multinucleated giant cells with intranuclear inclusion bodies.
Implications:
- This case highlights the potential for severe measles pneumonia in patients with concurrent EBV infection.
- Early diagnosis using serological and molecular methods is crucial.
- Pulse steroid therapy may be an effective treatment for severe measles pneumonia in these contexts.