Martin D B, Weiner L B, Nieburg P I, Blair D C
Ann Intern Med. 1979 Jun;90(6):877-81. doi: 10.7326/0003-4819-90-6-877.
Seven patients, aged 12 to 19 years, had atypical measles. Prodromal symptoms of fever, malaise, myalgia, headache, nausea, and vomiting were commonly followed by coryza, sore throat, conjunctivitis, photophobia, nonproductive cough, and pleuritic pain. The characteristic rash was erythematous, maculopapular, and progressed frequently to vesicular, petechial, or purpuric lesions. It initially involved palms and soles with subsequent spread to proximal extremities and the trunk, sparing the face. Six of six chest roentgenograms showed infiltrates. Findings not previously described in atypical measles included liver enzyme elevations, thrombocytopenia, disseminated intravascular coagulation, possible transmission among three siblings, and suspected cardiac involvement. Measles complement fixation titers compatible with recent infection were seen in all patients. All patients had previously received killed measles vaccine. A substantial number of persons who are older adolescents or young adults may be at risk of developing atypical measles.
7名年龄在12至19岁之间的患者患有非典型麻疹。前驱症状包括发热、不适、肌痛、头痛、恶心和呕吐，随后常出现鼻炎、咽痛、结膜炎、畏光、干咳和胸膜炎性疼痛。特征性皮疹为红斑性、斑丘疹，常进展为水疱性、瘀点性或紫癜性病变。皮疹最初累及手掌和足底，随后蔓延至近端肢体和躯干，面部不累及。6例胸部X线片均显示有浸润。非典型麻疹中以前未描述的发现包括肝酶升高、血小板减少、弥散性血管内凝血、可能在三名兄弟姐妹之间传播以及疑似心脏受累。所有患者的麻疹补体结合试验滴度均与近期感染相符。所有患者以前均接种过灭活麻疹疫苗。相当多的年龄较大的青少年或年轻成年人可能有患非典型麻疹的风险。
