Atypical Measles in Adolescents and Young Adults

Abstract

Seven patients aged 12-19 yr had atypical measles. Prodromal symptoms of fever, malaise, myalgia, headache, nausea and vomiting were commonly followed by coryza, sore throat, conjunctivitis, photophobia, nonproductive cough and pleuritic pain. The characteristic rash was erythematous, maculopapular and progressed frequently to vesicular, petechial or purpuric lesions. It initially involved palms and soles with subsequent spread to proximal extremities and the trunk, sparing the face. Of 6 chest roentgenograms, 6 showed infiltrates. Findings not previously described in atypical measles included liver enzyme elevations, thrombocytopenia, disseminated intravascular coagulation, possible transmission among 3 siblings and suspected cardiac involvement. Measles complement fixation titers compatible with recent infection were seen in all patients. All patients previously received killed measles vaccine. A substantial number of persons who are older adolescents or young adults may be at risk of developing atypical measles.