Clinical Manifestations
Clinical manifestations come in three stages:
- Pre-eruptive stage
a. Fever
b. Catarrhal symptoms ( rhinitis, conjunctivitis, photophobia, coryza)
c. Respiratory symptoms start from common colds to persistent coughing.
d. Enanthema signs (Koplik’s spots, Stimson’s line)
- Eruptive stage
a. The rash is usually seen late on the 4th day.
b. Maculo-papular rash appears first on either the cheeks, bridge of the nose, along the hairline, at the temple or at the earlobe.
c. The rash is fully developed by the end of the second day and all symptoms are at their maximum at this time.
d. High grade fever comes on and off.
e. Anorexia and irritability
f. Abdominal tympanism, pruritus, lethargy
g. The throat is red and often extremely sore.
h. As fever subsides, coughing may diminish, but more often it hangs on for a week or two, become looser and less metallic.
- Stage of convalescence
a. Rashes fade away in the manner as they erupted.
b. Fever subsides as eruption disappears.
c. When the rashes fade, desquamation begins.
d. Symptoms subside and appetite is restored.
Diagnostic Procedures
o Nose and throat swab
o Urinalysis
o Blood exams (CBC, leucopenia, leukocytosis)
o Complement fixation or hemogglutinin test
Modalities of Treatment
1. Anti-viral drugs (Isoprenosine)
2. Antibiotics if with complication
3. Supportive therapy (oxygen inhalation, IV fluids)
Complications
- Bronchopneumonia
- Otitis media
- Pneumonia/Bronchitis
- Nephritis
- Encephalitis; encephalomyelitis
- Blindness (seldom)
Unfavorable Signals
o Violent onset with high grade fever
o Fading eruption with rising fever
o Hemorrhagic or black measles
o Persistence of fever for ten days or more
o Slight eruptions accompanied by severe symptoms, especially those of encephalitis.