Clinical report of serious complications associated with measles pneumonia in children hospitalized at Shengjing hospital, China

Abstract

Introduction: Despite tremendous progress made toward elimination, measles continues to pose a great threat to the health of children in developing countries. The objective of this study was to summarize and analyze the clinical characteristics and treatment experience of serious complications of measles pneumonia in children. Methodology: The study group comprised 58 infants with severe measles pneumonia who were admitted to the Second Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, from December 2013 through May 2014. The clinical characteristics of complications such as hypoxemia, acute respiratory distress syndrome (ARDS), sepsis, pneumothorax, multiple organ dysfunction syndrome (MODS), and intracranial infection were retrospectively analyzed; in addition, the death cases were summarized and analyzed. Results: The 58 infants experienced the following: hypoxemia, 100%; ARDS, 21%; sepsis, 34%; pneumothorax, 14%; MODS, 16%; and intracranial infection, 9%. A total of 7 infants developed a secondary bacterial infection, and 12 infants received mechanical ventilation (5 with high-frequency mechanical ventilation and 3 with mechanical ventilation and NO inhalation); the average duration of mechanical ventilation was 10.08 days, and 3 infants expired. Conclusions: Children with measles pneumonia may experience multiple serious complications, among which ARDS and pneumothorax are particularly serious. If a patient's condition changes abruptly, it is crucial to promptly respond to the change and to administer mechanical ventilation and appropriate antibiotics. For patients with a severe pneumothorax, and especially those with severe mediastinal emphysema, timely, continuous, retrosternal, closed thoracic drainage can effectively relieve compression.

Features of toll-like receptor type 9 expression on immunocompetent peripheral blood cells of patients with measles infection of varying severity

“…One of the main complications of measles infection is the affection of the respiratory tract, namely out-of-hospital pneumonia which is the cause of high mortality among patients with measles [4,5]. During the last measles outbreak, which was observed on the territory of Ukraine in 2017-2019, high mortality rates were due not only to the action of the virus itself, but also to the addition of secondary bacterial flora and the development of out-of-hospital pneumonia, which against the background of immunosuppression caused by the direct action of the virus had a severe course even with the use of powerful antibacterial agents.…”

Measles - the public health challenge

“…Rijetko može nastati miokarditis. Neurološke se komplikacije očituju kao encefalitis koji može biti akutnog i kroničnog tijeka 37 . Akutni diseminirani encefalomijelitis javlja se u 1/1.000 oboljelih.…”

The Resurgence of Measles Infection and its Associated Complications in Early Childhood at a Tertiary Care Hospital in Peshawar, Pakistan

“…The death toll surged to approximately 0.16 million in 2011, with 95% of deaths reported from developing countries (WHO 2013). Presently, 45 million new measles cases were recorded, with one million deaths per year (Li et al 2015). In 2011, measles hit 4386 people in Pakistan, with 64 deaths reported.…”

“…After measles infection, secondary infections play a crucial role in measles-related deaths. Lower respiratory tract infections (LRTI) like bronchial pneumonia, are the leading cause of death in measles cases, particularly among children under 5 years of age (Li et al 2015). Other serious complications, particularly among immunocompromised and malnourished children, include blindness, acute diarrhea, otitis media, encephalitis, and myocarditis (WHO 2016).…”