Fatal measles (rubeola) pneumonia in adults

Fatal measles (rubeola) pneumonia, confirmed by viral culture and electron microscopy, occurred in a previously healthy 19-year-old man. Autopsy disclosed measles pneumonia but no recognizable disease that would predispose to such an infection. However, the prolonged course of the measles infection and very low levels of serum antibodies to measles indicate that an immune deficient state existed. Nearly all other adults dying of measles pneumonia have had impairment of the immune system, typically due to a lymphatic or hematologic malignant neoplasm treated with chemotherapy. An immunodeficient state may be a precondition for death from measles pneumonia in adults. Enlargement of air spaces with fibrosis in the anterior portions of both lungs is suspected to be due to tissue necrosis and high mechanical ventilatory pressures.