Bansal Jassimran, Hameed Aisha
Obstetrics and Gynaecology, King's College Hospital, London, UK.
Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK.
BMJ Case Rep. 2019 May 9;12(5):e228781. doi: 10.1136/bcr-2018-228781.
Measles is becoming more prevalent; it can be difficult to diagnose, with severe complications in pregnancy. We report a case of measles in a 27-year-old, parainfluenza virus type 2-infected woman who was 32 weeks pregnant. She presented with fever, tachycardia, sore throat and a pruritic rash. She never had the measles, mumps, rubella vaccine. Serology showed raised inflammatory markers with lymphopoenia. Throat swab showed parainfluenza virus. Chest radiography was normal. Despite appropriate antimicrobial therapy, she developed worsening respiratory failure requiring premature delivery via caesarean section.Postoperatively, she was transferred to a tertiary centre for extracorporeal membrane oxygenation. She was decannulated and made a full recovery. Meanwhile, her husband was diagnosed with measles. She was then tested and measles was confirmed. The baby did not develop congenital measles.This case emphasises the importance of vaccine histories at booking of pregnancy and early multidisciplinary team input to facilitate delivery in rapidly deteriorating pregnant women.
麻疹正变得越来越普遍；它可能难以诊断，在孕期会引发严重并发症。我们报告一例27岁、感染2型副流感病毒且怀孕32周的女性患麻疹的病例。她表现出发热、心动过速、喉咙痛和瘙痒性皮疹。她从未接种过麻疹、腮腺炎、风疹疫苗。血清学检查显示炎症标志物升高且淋巴细胞减少。咽拭子检查显示副流感病毒。胸部X线检查正常。尽管进行了适当的抗菌治疗，她仍出现了进行性加重的呼吸衰竭，需要通过剖宫产提前分娩。术后，她被转至三级医疗中心进行体外膜肺氧合治疗。她成功撤机并完全康复。与此同时，她的丈夫被诊断出患有麻疹。随后她接受检测，麻疹得到确诊。婴儿未患先天性麻疹。该病例强调了孕期建档时疫苗接种史的重要性，以及早期多学科团队介入对快速病情恶化的孕妇进行分娩的促进作用。
