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The Reemergence of Measles
Mary K Klassen-Fischer1, Ann M Nelson1, Ronald C Neafie1
1Joint Pathology Center, Silver Spring, MD, USA.
Objectives:
Present-day pathologists may be unfamiliar with the histopathologic features of measles, which is a reemerging disease. Awareness of these features may enable early diagnosis of measles in unsuspected cases, including those with an atypical presentation. Using archived tissue samples from historic patients, a unique source of histopathologic information about measles and other reemerging infectious diseases, we performed a comprehensive analysis of the histopathologic features of measles seen in commonly infected tissues during prodrome, active, and late phases of the disease.
Methods:
Subspecialty pathologists analyzed H&E-stained slides of specimens from 89 patients accessioned from 1919 to 1998 and correlated the histopathologic findings with clinical data.
Results:
Measles caused acute and chronic histopathologic changes, especially in the respiratory, lymphoid (including appendix and tonsils), and central nervous systems. Bacterial infections in lung and other organs contributed significantly to adverse outcomes, especially in immunocompromised patients.
Conclusions:
Certain histopathologic features, especially Warthin-Finkeldey cells and multinucleated giant cells without inclusions, allow pathologists to diagnose or suggest the diagnosis of measles in unsuspected cases.
Insights
Measles, a reemerging disease, presents distinct histopathologic features in tissues. Recognizing these changes, like Warthin-Finkeldey cells, aids early diagnosis in unexpected cases.
Area of Science:
- Pathology
- Infectious Diseases
- Histopathology
Background:
- Measles is a reemerging infectious disease.
- Pathologists may lack familiarity with measles' histopathologic features.
- Early diagnosis is crucial, especially for atypical presentations.
Observation:
- Analysis of archived tissue samples from 89 patients (1919-1998).
- Histopathologic features of measles were examined in respiratory, lymphoid, and central nervous systems.
- Correlation of histopathologic findings with clinical data was performed.
Findings:
- Measles induces acute and chronic histopathologic changes.
- Bacterial coinfections significantly impacted outcomes, particularly in immunocompromised individuals.
- Specific features like Warthin-Finkeldey cells and multinucleated giant cells aid diagnosis.
Implications:
- Enhanced awareness of measles histopathology can improve diagnostic accuracy.
- Identification of key cellular changes assists in diagnosing unsuspected measles cases.
- Understanding disease phases and coinfections is vital for patient management.
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