A 6-year-old boy from Northern Cebu developed rhinorrhea and a mild non-

productive cough 8 days before admission to Vicente Sotto Memorial

Medical Center (VSMMC). Six days before admission to VSMMC, he
developed a tactile fever and was taken to a local health center. He was
prescribed a mucolytic and an antihistamine. Despite this treatment, his
cough worsened and his fever persisted. Three days before admission to
VSMMC, he developed a facial rash, which proceeded to spread to his
trunk. On the day before admission to VMMC his fever and cough
persisted, and he was transferred to VSMMC for severe respiratory distress
and potential need for mechanical ventilation.

The child had no medical or surgical history. He did not take any
medications. His birth history was unremarkable. He had no known drug
allergies. His vaccination history included: BCG vaccine; diphtheria,
pertussis and tetanus vaccine; oral poliovirus vaccine (three doses); and
hepatitis B vaccine (three doses).

On the patient’s admission to VSMMC, he was febrile (39.5°C), tachycardic

(110–120 beats/min) and tachypneic (40 respirations/min). The child
appeared ill and had bilateral conjunctivitis, a normal oropharynx,
decreased breath sounds with fine crepitation throughout, mild subcostal
retractions and a generalized erythematous maculopapular rash with
confluence on face, trunk and extremities
Labs and Imaging

Complete Blood Count

WBC count 9,900
Neutrophils 41
Lymphocytes 42
Monocytes 3
Eosinophils 4
Basophils 0
RBC count 3.5 x106/ml
Hemoglobin 10 g/dl
Hematocrit 29.4%
Platelet count 300,000

Measles IgM was reactive.

Chest radiograph showed patchy infiltration in bilateral perihilar regions, without

pleural effusion or cardiomegaly. Studies were completed 8 days after symptom
onset.
CXR 8 days after symptoms onset (3 days after rash onset)

CXR 10 days after symptom onset (5 days after rash onset)

Blood Cultures had no growth at 7 days

Guide Questions:

1. What is the diagnosis?

2. What is the causative organism?
3. How does this disease spread?
4. How long does it take to show signs and symptoms of the disease?
5. What is the pathophysiology of this disease?
6. What are the signs and symptoms of this disease?
7. What are the complications?
8. How do you diagnose this disease?
9. What is the treatment for this disease?
10.What are the methods of prevention?