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孕期麻疹的揭示:资源受限环境下一例致命的罕见孕产妇麻疹死后诊断病例

Unmasking measles in pregnancy: A fatal rare case of maternal measles with posthumous diagnosis in a resource-constrained setting.

作者信息

Lugata John, Mrosso Onesmo, Lyamuya Tecla, Swai Patricia, Mjema Rafiki, Kilonzo Kajiru, Mchome Bariki, Batchu Nasra

机构信息

Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

School of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

出版信息

Radiol Case Rep. 2025 Jun 28;20(9):4749-4754. doi: 10.1016/j.radcr.2025.06.039. eCollection 2025 Sep.

Abstract

Measles, a highly contagious viral airborne disease, continues to loom as a public health concern worldwide. Despite the availability of an effective measles vaccine, maintaining a vaccine coverage of at least 95% is imperative to uphold herd immunity, which acts as a crucial barrier against the disease's resurgence. This safeguard against measles resurgence remains vulnerable, as outbreaks can occur in pockets of susceptible population where there is low vaccine uptake, even in regions that seemingly maintain satisfactory average vaccination coverage. We present a rare case from northern Tanzania of a 20-year-old female at 28 weeks of gestation age who presented with persistent cough with bloody sputum, chest pain, fevers, epistaxis, and episodes of bloody diarrhea. A postmortem examination was conducted and the findings revealed pathognomonic features of measles. Serum IgM was tested positive for measles result confirming the diagnosis. This rare case report of the pregnant woman with a posthumous diagnosis of measles emphasizes the ongoing complexities in diagnosing and managing measles. It highlights the necessity for an integrative diagnostic approach and heightened clinical awareness, particularly in resource-limited environments.

摘要

麻疹是一种极具传染性的病毒性空气传播疾病,在全球范围内仍然是一个公共卫生问题。尽管有有效的麻疹疫苗,但维持至少95%的疫苗接种覆盖率对于维持群体免疫至关重要,群体免疫是防止该疾病卷土重来的关键屏障。这种防止麻疹卷土重来的保障措施仍然很脆弱,因为即使在看似维持了令人满意的平均疫苗接种覆盖率的地区,在疫苗接种率低的易感人群聚集区也可能发生疫情。我们报告了坦桑尼亚北部一个罕见病例,一名20岁女性,孕28周,出现持续咳嗽伴血痰、胸痛、发热、鼻出血和血性腹泻。进行了尸检,结果显示有麻疹的特征性表现。血清IgM检测麻疹呈阳性,确诊了诊断。这例罕见的孕妇死后诊断为麻疹的病例报告强调了麻疹诊断和管理中持续存在的复杂性。它突出了综合诊断方法和提高临床意识的必要性,特别是在资源有限的环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a44/12268182/a6f5af67496d/gr1.jpg

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