Clinical and Laboratory evaluation of measleslike rash in children and young adults

• Main Authors: Stewien Klaus Eberhard, Lima Lourdes Rehder de Andrade Vaz de, Botosso Viviane Fongaro, Oliveira Maria Isabel de, Fagundes Simone N., Nogueira Meri B., Ragazzi Selma Lopes Betta, Costa Maria Tereza Zuluni da, Ejzenberg Bernardo, Durigon Edison Luiz
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Microbiologia 2000-01-01
• Series: Brazilian Journal of Microbiology
• Subjects: measles; clinical evaluation; laboratory investigation; polymerase chain reaction; measles virus isolation; enzyme immunoassay
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1517-83822000000400008
• ISSN: 1517-8382; 1678-4405

A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases), scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.