Truncal rash in adult measles

Abstract

36 37 1 38 39 40 41 42 a non-productive cough of several days’ duration. Both had truncal rashes and Koplik’s spots on the oral mucosa. Measles was confirmed by positive serologic test for serum measles IgM antibody in each patient. The first patient showed intestinal pneumonia with hypoxemia (PaO2, 57.5 mmHg), while the second had elevated levels of liver enzymes (aspartate aminotransferase 364 IU/l, alanine aminotransferase 285 IU/l). They both required hospitalization for several days. The rash (Figures 1 and 2) was characterized by a small speckled appearance and progressed rapidly, spreading from the head to the extremities within 24–48 h. They had not been vaccinated against measles. In Japan, immunization against measles was made compulsory in 1978; the measles–mumps–rubella (MMR) vaccine was discontinued once in 1993 . There were 18 000 cases of measles in patients aged <15 years in 2007. In 2008, at least 9631 cases of measles were reported during the first half of the year; 4229 (43.9%) of these cases occurred in Tokyo and 5794 (60.2%) cases were in persons aged 15 years. Of note, only 104 (4.1%) had received the second dose of measles vaccine. The low immunization rate, 43 44 45 46 47 48 § This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.