Case 23-2014: Fevers, rash, pancytopenia, and abnormal liver function: To the editor

摘要

I would like to raise an issue with regard to the Case Record (July 24 issue) by Hay et al. It was stated that a chest radiograph showed a faint, patchy opacity in the left lower lobe that may represent pneumonia. Pneumonia in measles results from either direct viral inva: sion or secondary infection; the pathogen is Staphylococcus aureus or Streptococcus pneumoniae in most cases. It is crucial to eliminate pneumonia, because pneumonia is responsible for 60% of measles-associated deaths. Under the circumstances, computed tomography (CT) should be considered, and sequential chest radiographs should be obtained. If opacities are observed on CT and the patient's condition permits, broncho-alveolar lavage and transbronchial lung biopsy could be performed by means of flexible bron-choscopy.