Measles face

Introduction Measles face: Both eyes are reddish and afraid of light, the secretions in the eyes increase, nasal obstruction, accompanied by fever. Measles is an acute respiratory infection caused by the measles virus. The clinical symptoms include fever, cough, runny nose, conjunctival hyperemia, and Koplik's spots on the oral mucosa. Simple measles has a good prognosis, and the mortality rate of critically ill patients is high. The rash period of measles is characterized by aggravation of systemic poisoning, body temperature as high as 40 ° C, apathetic, lethargy, and sometimes convulsions. Facial edema, skin diagnosis, increased eye secretions, and even adhesions of eyelids are not easy to open, and the flow is thick, the appearance of the above expression is called measles face.

Cause

Source of infection

The patient is the only source of infection. From the 2nd day before the onset (end of the incubation period) to 5d after the rash, the conjunctival secretions, nasal, oropharynx, and tracheal secretions contain viruses and are infectious. The recovery period does not carry a virus.

way for spreading

It is mainly transmitted directly through droplets, and indirect transmission of clothing and toys is rare.

Susceptible population

The population is generally susceptible. More than 90% of the susceptible people are exposed to the disease. Long-lasting immunity after illness. Adults are more susceptible to measles or measles vaccination because of their immunity. Infants can be protected by maternal antibodies within 6 months. However, due to the measles vaccination, the natural infection rate of measles decreased, the antibody level of women of childbearing age decreased, and the protective ability to infants also decreased.

Popular feature

The onset season is mostly in winter and spring, but it can occur from cases throughout the year. In China, the incidence rate of children from 6 months to 5 years old is the highest. In recent years, due to the results of long-term vaccine immunization, the epidemic intensity of measles has weakened, and the average age of onset has shifted. Floating population or immune blanks are likely to cause accumulation of susceptible people in urban areas, leading to local measles outbreaks.

an examination

Related inspection

Measles virus antibody against measles virus antibody

Both eyes are reddish and afraid of light, the secretions in the eyes increase, nasal obstruction, accompanied by fever and cough. The face of a healthy person should be a god with two eyes, a delicate eyebrow and a shiny skin.

First, blood routine examination: the total number of white blood cells decreased, lymphocytes increased relatively.

Second, serological antibody test: in the acute phase and recovery period, the serum antibody titer increased by 4 times to increase as positive. At present, ELISA is used to measure specific IgM and IgG antibodies in the blood. IgM is more positive after 3 days of rash, and IgM peaks at 2 weeks. However, about 7.9% of IgM antibodies in adult measles measles are always negative.

3. Pathogen examination: taking the eyes, nose and pharyngeal secretions of the patients in the prodromal or rash stage, inoculation of blood and urine specimens into primary human embryonic kidney cells or amniotic cells, separating measles virus; or detecting by indirect immunofluorescence The intracellular measles virus antigen in the tablet; the measles virus RNA can also be determined by nucleic acid hybridization using a labeled measles virus cDNA probe.

Fourth, check the nuclear giant cells: take the patient's nasopharyngeal secretions, sputum and urine sediment smear, check the multinucleated giant cells with Wright's stain, or you can find the measles virus particles in the outer culverts of the multinucleated giant cells by electron microscopy. Multinucleated giant cells had a high positive rate from 2 days before rash to 1 day after rash.

According to the epidemic situation, contact history, past history and vaccination history, clinical fever, catarrh, combined with membrane inflammation, mucosal plaque and typical rash diagnosis is not difficult. Atypical cases need to be diagnosed with immunology.

Differential diagnosis

Differential diagnosis of measles face:

1. Chronic face: The face is gray or pale, the face is stunned, and the gaze is dim. Common in chronic wasting diseases, such as cirrhosis, malignant tumors, severe tuberculosis.

2, anemia face: pale and dull, eyelids, lips and tongue pale, expression tired and weak.

3, typhoid face: expression is indifferent, slow response, showing no desire. Mostly, the face of patients with high fever and fever, such as typhoid fever, encephalitis, and meningitis.

4, scarlet hot face: facial congestion and redness, the skin around the nose and mouth is obviously pale.

5, cachexia quality face: face is extremely thin, pale complexion, skin elasticity is poor. Both eyes are reddish and afraid of light, the secretions in the eyes increase, nasal obstruction, accompanied by fever and cough. The face of a healthy person should be a god with two eyes, a delicate eyebrow and a shiny skin.

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