A 35-year-old man, who received a measles vaccination at 2 years of age, developed a 38.5℃ fever 2 days after displaying catarrhal symptoms, and milia-like papules of approximately 1-mm in size extending from the face to the trunk and extremities. However, no fused papules were found (Picture1～3). Koplik's spot was not observed in the oral mucosa. The EIA method, revealed that the patient's measles-IgM antibody titer was 1:9.26, and his measles-IgG antibody titer was 1:128 or lower. A measles RT-PCR showed the presence of measles RNA in throat swab specimens, the further sequencing of the PCR products revealed the measles B3 genotype. We therefore diagnosed the patient with modified measles.
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Modified measles is difficult to diagnose because of the absence of typical symptoms during outbreaks (1); however, measles is highly infectious, and should be rapidly diagnosed.
The authors state that they have no Conflict of Interest (COI).
References
- 1. Nakajima N, Ueda M, Yamazaki M, Takahashi T, Katayama Y. Optic neuritis following aseptic meningitis associated with modified measles: a case report. Jpn J Infect Dis 66: 320-322, 2013. [DOI] [PubMed] [Google Scholar]