Measles laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Diagnosis

Clinical diagnosis of measles requires a history of fever of at least three days together with at least one of the three Cs. Observation of Koplik's spots is also diagnostic of measles.

Alternatively, laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or isolation of measles virus RNA from respiratory specimens. In cases of measles infection following secondary vaccine failure IgM antibody may not be present. In these cases serological confirmation may be made by showing IgG antibody rises by Enzyme immunoasay or complement fixation.

Positive contact with other patients known to have measles adds strong epidemiological evidence to the diagnosis.

Some patients will develop pneumonia as a sequela to the measles. Histologically, a unique cell can be found in the paracortical region of hyperplastic lymph nodes in patients affected with this condition. This cell, known as the Warthin-Finkeldey cell, is a multinucleated giant with eosinophilic cytoplasmic and nuclear inclusions.