Encephalitis, meningitis: Dangerous complications of measles

The article was professionally consulted by Specialist Doctor I Bui Thi Ha - Pediatrician - Neonatologist, Department of Pediatrics - Neonatology - Vinmec Ha Long International Hospital

With measles, children are more susceptible to complications due to the attack of bacteria due to superinfection or virus. One of the most dangerous complications is encephalitis and meningitis.

A and coma.
When there is acute encephalitis, the cerebrospinal fluid has increased lymphocytes and increased protein. The mortality rate in patients with acute encephalitis due to measles is about 15%, the rate of neurological damage for patients is 25%.
Meningitis is a dangerous neurological complication that is fatal and has the potential to leave sequelae for patients. Meningitis is classified differently based on the cause of the disease, which can be serological meningitis caused by measles virus or meningitis after otitis due to superinfection.
In addition, measles can also cause a number of other complications in the brain such as:
Subacute fibrotic white matter inflammation: This is a rare complication, difficult to predict and leaves a serious condition. The disease is common between the ages of 2 and 20. The disease appears late after a few years of measles, because the measles virus can live for many years in the patient's body with an abnormal immune response. Complications can last from several months to a year and lead to death due to increased muscle tone and cerebral spasticity. Subacute sclerosing panencephalitis: a degenerative CNS disease caused by persistent measles virus brain infection. The disease begins slowly, without acute signs, slowly declines in behavior and intelligence, then appears ataxia, myoclonus.

Complications in the early stage: The early stage complications of the rash usually disappear with the disappearance of the rash, causing shortness of breath due to laryngospasm. Oral mucositis is also a complication that often occurs in the early stages and usually resolves with the rash. However, complications can occur in the late stages of measles due to superinfection.

Complications in the late stage: Complications appear after rash, due to superinfection (common due to staphylococci, streptococci, pneumococcal...):
Bronchitis: Appears at the end of the rash period. Patients often have symptoms of fever again, cough much, bronchial rales on auscultation, increased white blood cells, increased neutrophils, and chest X-ray shows bronchitis. Bronchitis - lung: Appears late after eruption. More severe manifestations of bronchitis include: high fever, difficulty breathing, pulmonary examination with bronchial rales and crackles, X-ray images of bronchial inflammation (scattered faint nodules in both lungs). Laboratory results showed increased white blood cells, increased neutrophils. Gastrointestinal complications: Oral mucositis, enteritis, and diarrhea are common complications in children with measles. Corneal ulcers: Seen in malnourished children, vitamin A deficiency and can cause permanent blindness. Pregnant women who get measles are at increased risk of miscarriage, stillbirth, premature birth, or low birth weight. The disease often appears late, due to a superinfection with a gangrene bacteria that causes ulcers in the oral mucosa, spreading to the jawbone, causing mucosal necrosis, bone inflammation, tooth loss, and bad breath. Severe malnutrition after measles infection affects the long-term development of children.

There is still no specific treatment for measles. Treatment is mainly symptom reduction, personal hygiene and proper nutrition:
Isolating sick children from healthy children. It is necessary to maintain personal hygiene, clean the house and the surrounding environment, keep the living place ventilated and clean to avoid opportunistic infections. Improve children's resistance with proper nutrition. Drink lots of fruit juices, eat liquids, and increase foods rich in vitamins, especially vitamin A, to protect the eyes of children with measles. Children with vitamin A deficiency will be supplemented with high doses of vitamin A for 2 consecutive days as prescribed by the doctor. Abstinence from bathing, abstaining from wind, and keeping the child covered will make the disease worse. Pay attention to take the child to the hospital when the child has a fever and cough.