| Title | The Conundrum in the Diagnosis and Management of Atypical Fulminant Measles in a Leukemia Survivor on Maintenance Chemotherapy. | ||
| Author | Huang, James Guoxian; Yeoh, Allen Eng Juh; Tambyah, Paul Anantharajah; Suhaila, Mas Isa | ||
| Journal | J Pediatr Hematol Oncol | Publication Year/Month | 2017-Jan |
| PMID | 27992394 | PMCID | -N/A- |
| Affiliation | 1.*Khoo Teck Puat-National University Children's Medical Institutedouble daggerDepartment of Medicine, National University Health SystemDepartments of daggerPaediatrics section signMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. | ||
We report the diagnostic and therapeutic challenges in an unusually fulminant presentation of measles, presenting as severe necrotizing bronchiolitis with secondary hemophagocytic lymphohistiocytosis (HLH) in the absence of classical clinical features in an immunocompromised host on maintenance chemotherapy. Our patient had presented with features of a viral pneumonitis without the classical exanthem, in combination with HLH. Although rhinovirus-induced HLH was highly unusual, the positive rhinovirus swab result had distracted us from the eventual diagnosis. This calls for greater impetus to increase awareness and public education to improve vaccination rates and herd immunity to curb outbreaks and protect the immunocompromised patients.