Complications of measles

Main types of complications

Despite the fact that uncomplicated infection is often treated at home, the development of pathological conditions requires transferring the patient to a hospital. Based on the clinical picture, complications can be divided into several groups:

• Neurological lesions: measles encephalitis and meningoencephalitis. These are extremely severe conditions accompanied by pronounced edema of brain tissue and requiring emergency intensive care.
• Respiratory disorders: development of false croup. Characterized by acute respiratory impairment due to laryngeal damage.
• Bacterial infections: secondary infection against the background of weakened immunity. May manifest as severe purulent lesions (e.g., formation of purulent crusts on the conjunctiva of the eyes).
• Local inflammatory processes: development of pronounced stomatitis in the oral cavity during the peak period of the disease.

Treatment tactics for complicated forms

The addition of complications is a direct clinical indication for hospitalization in specialized departments or boxed wards. Therapy is selected individually depending on the nature of the lesion.

Treatment of bacterial complications

Immediate antibiotic therapy is prescribed. The following drug groups are used:

1. Macrolides (roxithromycin, azithromycin).
2. Semisynthetic penicillins (Augmentin, Amoxiclav).
3. First- to second-generation cephalosporins.

As pathogenetic support, parenteral detoxification is performed—intravenous administration of glucose-saline solutions enriched with ascorbic acid. To relieve severe inflammatory processes, glucocorticosteroids (prednisolone) are prescribed parenterally for a short course. The use of interferon preparations (Viferon, Reaferon) may also be discussed.

Management of false croup

With manifestations of laryngeal stenosis, the basis of therapy becomes mucolytics and bronchodilators. They can be used in various ways, but the inhalation route of administration is considered the most effective.

Therapy for measles encephalitis

Treatment is built on the principles of intensive care. The main task is the elimination of cerebral edema. Mandatory measures include:

• Active detoxification and dehydration.
• Thorough correction of metabolic disorders.
• Use of anticonvulsants and sedatives.
• Prescription of glucocorticosteroids (GCS).

Antiepidemic measures and discharge

The development of complications introduces adjustments to the epidemiological regimen.

Isolation periods: While in a standard course the patient is isolated until the 5th day from the onset of the rash, in a complicated form this period is necessarily increased to the 10th day.

Hospital discharge: Performed only after complete clinical recovery of the patient and reliable relief of all complications. However, regardless of the recovery rate, the convalescent can be discharged no earlier than the 10th day from the onset of the disease.

Features of diagnosis formulation

A detailed clinical diagnosis must clearly reflect the severity of the patient's condition. When formulating it, the physician is required to indicate three key elements: clinical form (typical/atypical), severity of the course, and the complication itself.

Example of correct entry: Measles, severe course. Complication: meningoencephalitis. (The diagnosis is confirmed laboratory-wise, e.g., by a sharply positive ELISA reaction for IgM class antibodies).

Briefly: answers to topical questions

Class and exam questions

What else to study on this topic

• Stages of diagnostic search in measles
• Differential diagnosis with rubella and scarlet fever
• Specific laboratory diagnostics (ELISA, IHA, HIFA)
• Algorithm for passive and active immunization of contacts
• Symptoms of the catarrhal period and Koplik spots

Other topics in the "Respiratory Infections" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.