1/73. SSPE following neonatal measles infection.The authors report a case of subacute sclerosing panencephalitis in a child who had measles during the neonatal period. At 3 years, 6 months of age, over a period of a few weeks, the patient lost the ability to sit unaided as a result of progressive truncal ataxia, without apparent cognitive changes, simulating acute cerebellar ataxia. His symptoms improved in 1 month, and he was able to walk again with support, but mental alteration and periodic mild head nodding on awakening followed. His illness was diagnosed as subacute sclerosing panencephalitis on the basis of the elevated titers of measles antibodies in the cerebrospinal fluid. Measles infection before 1 year of age is a risk factor of subacute sclerosing panencephalitis, but reports about patients with neonatal measles infection are rare. Immaturity of the brain at the time of measles infection may not only be a risk factor but may also influence the clinical course of the disease.- - - - - - - - - - ranking = 1keywords = illness, ill (Clic here for more details about this article) |
2/73. Isolation of measles virus from a naturally-immune, asymptomatically re-infected individual.BACKGROUND: The changing epidemiology of measles with mild measles cases increasingly being recognised in previously-vaccinated individuals, suggests that more asymptomatic or subclinical cases might be occurring. Although this has been clearly documented in previously-vaccinated individuals, the frequency of these asymptomatic infections in individuals previously naturally-infected with measles is not known. Also, it is not known whether these asymptomatic or mildly-infected individuals who do not display the full range of clinical signs of measles are capable of transmitting the virus to other susceptible persons. OBJECTIVES: To demonstrate the isolation of measles virus (MV) from previously, naturally-immune individuals asymptomatically infected with measles while in close contact with acutely infected family members and to document the secondary immune responses (SIR) associated with asymptomatic measles infection. STUDY DESIGN: Throat swab and urine specimens from five acute measles cases and their family contacts, taken within 5 days of onset of rash in each acute case, were used to isolate MV by tissue culture. Positive tissue culture results were confirmed by indirect immunofluorescence (IF) staining. Measles specific antibodies (IgG and IgM), IgG urea avidity and measles-neutralising antibodies were measured in the one family (index family) where an asymptomatic measles infection of a contact was demonstrated. RESULTS: The acutely infected patient in the index family (T1/96) had a measles-neutralising antibody titre of < 1:10, measles IgG urea avidity of 24% and MV was isolated and confirmed by IF from urine and throat swab specimens. T1/96 represents acute measles infection after primary vaccine failure because he had a clear history of being vaccinated against measles as a child. MV was also successfully isolated from throat swab and urine specimens from the other four acute cases and from the urine but not the throat swab of an asymptomatically infected family contact in the index family (mother, T2/96). T2/96 had a history of natural measles infection as a child approximately 50 years ago. In addition to detectable MV in urine this contact also had a SIR with a rise in measles specific neutralising antibody titre. No virus was isolated from the other contact in the index family (father, T3/96) or from the contacts of the other four acute cases examined. CONCLUSIONS: This is the first report of a confirmed asymptomatic MV infection, by MV isolation and IF testing and a concurrent SIR, in a previously naturally-immune contact of an acute case. The importance of these findings to the epidemiology and control of MV as well as the diagnostic value of MV urine isolation and IF confirmation for mild or asymptomatic cases must be examined further.- - - - - - - - - - ranking = 13.320796833621keywords = person (Clic here for more details about this article) |
3/73. What is the cause of a rash after measles-mumps-rubella vaccination?Surveillance and laboratory confirmation of measles will increase in importance as australia implements enhanced measles control. We describe a 17-month-old child with fever and rash after measles-mumps-rubella vaccination. Detection of vaccine-strain measles virus in his urine by polymerase chain reaction confirmed the diagnosis of a vaccine reaction rather than wild-type measles. We propose that measles virus should be sought and identified as vaccine or wild-type virus when the relationship between vaccination and measles-like illness is uncertain.- - - - - - - - - - ranking = 1.1494938608064keywords = illness, ill (Clic here for more details about this article) |
4/73. Unusual encephalitic illnesses in a child with acute leukaemia in remission: possible role of measles virus and toxoplasma gondii.We report a girl who developed an encephalitic illness with visual loss after two years treatment for acute lymphoblastic leukaemia. The visual loss was found to be due to bilateral macular degeneration. She later developed radiological evidence of intracranial calcification and temporal lobe epilepsy. A second episode of encephalitis occurred when she had been off all antileukaemic treatment for three years and this left her with a right hemiparesis. Investigation suggested involvement with both measles virus and toxoplasma gondii as a cause for these illnesses.- - - - - - - - - - ranking = 6keywords = illness, ill (Clic here for more details about this article) |
5/73. subacute sclerosing panencephalitis, a measles complication, in an internationally adopted child.A healthy 13-year-old boy who had spent the first 4.5 years of his life in an orphanage in thailand before adoption by an American couple became ill with subacute sclerosing panencephalitis and died several months later. The boy had most likely contracted wild-type measles in thailand. Measles complications are a risk in international adoptions.- - - - - - - - - - ranking = 0.074746930403213keywords = ill (Clic here for more details about this article) |
6/73. Rapid progressive subacute sclerosing panencephalitis in a 2-year-old child with congenital athyreosis.We present the unique case of a 2-year-old girl with congenital athyreosis who acquired primary measles virus infection at the age of 18 months, coincidentally with an Epstein-Barr virus infection. First neurologic symptoms of subacute sclerosing panencephalitis appeared 5 months later, and the girl died within 6 months after a rapid progressive illness. Factors possibly predisposing to this extraordinary disease course-primary measles virus infection at an early age and lack of evidence for immunodeficiency-are discussed.- - - - - - - - - - ranking = 1keywords = illness, ill (Clic here for more details about this article) |
7/73. Acute measles gastric infection.We describe the case of a 44-year-old man who was referred for gastroscopy because of abdominal pain. During endoscopy, inflammatory changes of the antrum and corpus mucosa were clearly visible, and biopsy samples from the antrum and corpus mucosa were taken. At histology, routine hematoxylin and eosin staining showed characteristics indicative of so-called ex-helicobacter pylori-gastritis that had developed after antibiotic treatment 2 years ago. Additional large, bizarre inclusion bodies and clusters of multinucleated giant cells were located in the surface epithelium and within the lamina propria. These giant cells had an appearance similar to that of Warthin-Finkeldey cells, which can be found during the prodromal phase of measles infection. Anti-measles virus immunochemistry showed a strong positivity for measles virus antigen within the giant cells. Based on these results, the final diagnosis of morbilliform gastritis was made. To our knowledge, no case of measles gastritis has been described in the literature. Our case report confirms the systemic character of measles virus infection and confirms that measles viral replication can involve the gastric mucosa in addition to the conjunctiva, lung, and intestina.- - - - - - - - - - ranking = 0.074746930403213keywords = ill (Clic here for more details about this article) |
8/73. measles virus infection in the placenta of monozygotic twins.We report a case of monozygotic twins whose mother was infected with measles at 19 weeks' gestation. One of the twins died in utero at 32 weeks' gestation. The placenta of the stillbirth showed massive fibrin deposition, and some residual trophoblasts contained many inclusion bodies positive for measles virus antigen. Fetal organs and cells other than a few splenic lymphocytes showed no evidence of measles virus infection. The placenta of the surviving infant showed focal intervillous fibrin deposits, and only a few syncytiotrophoblasts were positive for measles virus antigen. At present, 7 months after the delivery, the surviving infant has not developed any sign of measles virus infection. Postpartum course of the mother has been uneventful, although high titers of serum anti-measles virus IgM persisted for 6 months after delivery. This case is informative in the following respects: the villous trophoblasts had diagnostic inclusion bodies and ultrastructural evidence of measles virus infection, the degree of viral involvement within the monochorionic placenta was uneven, both of the twins were virtually free from measles virus infection despite the marked involvement of the placenta, and measles virus infection had persisted in the monochorionic placenta for approximately 13 weeks.- - - - - - - - - - ranking = 0.22424079120964keywords = ill (Clic here for more details about this article) |
9/73. subacute sclerosing panencephalitis.subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder of childhood and early adolescence. It is caused by persistent defective measles virus. brain biopsies or postmortem histopathological examination show evidence of astrogliosis, neuronal loss, degeneration of dendrites, demyelination, neurofibrillary tangles, and infiltration of inflammatory cells. patients usually have behavioral changes, myoclonus, dementia, visual disturbances, and pyramidal and extrapyramidal signs. The disease has a gradual progressive course leading to death within 1-3 years. The diagnosis is based upon characteristic clinical manifestations, the presence of characteristic periodic EEG discharges, and demonstration of raised antibody titre against measles in the plasma and cerebrospinal fluid. Treatment for SSPE is still undetermined. A combination of oral isoprinosine (Inosiplex) and intraventricular interferon alfa appears to be the best effective treatment. patients responding to treatment need to receive it life long. Effective immunisation against measles is the only solution presently available to the problem of this dreaded disease.- - - - - - - - - - ranking = 0.14949386080643keywords = ill (Clic here for more details about this article) |
10/73. Detection of measles virus genomic rna in tear samples from a patient with measles keratitis.PURPOSE: To report a case of measles keratitis, in which measles virus genomic rna was detected in tear samples. methods: Samples of tears and pharyngeal mucus were obtained from a 19-year-old man with active systemic measles on day 7 after illness onset. These specimens were then subjected to reverse-transcriptase polymerase chain reaction (RT-PCR), using measles-specific primers. RESULTS: One week after systemic measles outbreak, the patient presented with a chief complaint of irritation in both eyes. Slit-lamp examination revealed bilateral superficial punctate keratopathy in the central cornea with small diffuse subepithelial infiltrations, and RT-PCR detected measles virus genomic rna in tears and pharyngeal mucus. The patient was treated with topical 0.1% fluorometholone and 0.5% levofloxacin three times a day for 1 week, and the keratopathy resolved without sequelae. CONCLUSION: This report demonstrates for the first time the presence of measles virus genomic rna in the tears of a patient with measles keratitis. It also highlights the utility of RT-PCR for rapid detection of measles rna in tear or mucus samples. Furthermore, the presence of virus in bodily fluids and secretions signifies the potential contagiousness of this type of keratopathy.- - - - - - - - - - ranking = 1keywords = illness, ill (Clic here for more details about this article) |
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