Clinical presentations and complications of suspected measles in hospitalized children

Area of Science:

• Pediatrics
• Infectious Diseases
• Epidemiology

Background:

• Measles outbreaks present diagnostic challenges, especially in young children.
• Clinical presentations of measles can be atypical, complicating diagnosis.
• Differential diagnoses include Kawasaki disease and toxic shock syndrome.

Purpose of the Study:

• To evaluate clinical presentations and complications of suspected measles in pediatric patients during an epidemic.
• To identify features that distinguish measles from Kawasaki disease and toxic shock syndrome.

Main Methods:

• Retrospective review of 48 hospitalized pediatric patients with suspected measles.
• Analysis of clinical data, including symptoms, complications, and diagnostic criteria.
• Comparison of laboratory markers (platelet count, ESR) and echocardiographic findings.

Main Results:

• 44 patients diagnosed with measles; 18 culture-proved.
• Atypical presentations were common, including respiratory issues, otitis media, hepatitis, keratitis, and CNS involvement.
• Six patients with stomatitis and measles-like illness met criteria for Kawasaki disease (3 diagnosed with each).
• Two of 10 hypotensive patients met criteria for toxic shock syndrome.

Conclusions:

• Diagnosing measles solely on clinical grounds can be challenging due to overlapping symptoms with other conditions.
• Platelet count and erythrocyte sedimentation rate may aid in distinguishing measles from Kawasaki disease.
• Hypotension and stomatitis warrant consideration of Kawasaki disease and toxic shock syndrome in measles-like illnesses.