Measles: diagnosis
Last reviewed: 23.04.2024
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In conditions of low incidence of measles diagnosis is complex and involves an assessment of the epidemic situation in the patient's environment, clinical observation in the dynamics and serological examination. A typical measles with spots of Filatov-Belsky-Koplik, cough, runny nose, conjunctivitis and a rash that appears first on the head, can easily be diagnosed on the basis of a clinical picture.
The main laboratory diagnosis of measles is a general blood test and a serological blood test using the RPHA, RTGA, RSK, or ELISA.
- General blood analysis. Characterized by lymphopenia and neutropenia, which is associated with the multiplication of the virus in leukocytes and their subsequent death. Leukocytosis is indicative of an attached bacterial infection.
- Serological methods of research. ELISA is the most sensitive, it determines the IgM titer. Therefore, in order to confirm the diagnosis, it is sufficient to examine serum taken in the acute phase of the disease only once, IgM becomes available in the first 2 days after the appearance of the rash, IgG after 10 days and reach its maximum values after 18-22 days. Before the onset of rash, the RNA of the virus is detected by the PCR method when examining blood and smears from the throat.
- Spinal puncture. It is carried out with the subsequent analysis of cerebrospinal fluid in case of suspected development of measles encephalitis. Lymphocytosis and increased protein levels are detected.
- RIF swab secret respiratory tract. Conjugated with fluorescein monoclonal antibodies are used to detect measles virus antigens. In smears stained with conventional methods, giant multinucleate cells are found. With the development of croup, sowing is carried out from the tonsils and from the nose to determine the causative agent of diphtheria.
- Study of the coagulation system of blood. Produced in the development of hemorrhagic syndrome.
Instrumental diagnosis of measles (chest radiography, echocardiography) is used for suspected complications.
Differential diagnosis of measles is carried out with rubella, scarlet fever, infectious mononucleosis (with ampicillin treatment), allergic rashes.
[Indications for consultation of other specialists
With the development of otitis media, laryngitis and laryngotracheitis, consultation of the otorhinolaryngologist with subsequent correction of therapy, as well as physician-physiotherapist is shown.
With a prolonged course of conjunctivitis, the development of keratoconjunctivitis requires consultation of an ophthalmologist, and if there is a suspicion of encephalitis or meningoencephalitis, a neurologist.
Indications for hospitalization
Measles requires hospitalization in the following cases: severe and complicated forms of the disease, children from shelters, orphanages, hostels, socially disadvantaged families.