What is the most common complication of measles?

Most Common Complication of Measles

The most common complication of measles is pneumonia (option C). According to the most recent and high-quality evidence from the CDC, pneumonia accounts for most measles-associated morbidity and mortality 1.

Complications of Measles

Measles can lead to various complications affecting multiple organ systems:

• Respiratory complications:

  • Pneumonia (most common and serious complication)
  • Laryngotracheobronchitis
  • Respiratory insufficiency

• Other common complications:

  • Otitis media
  • Diarrhea
  • Stomatitis

• Neurological complications:

  • Encephalitis (occurs in approximately 1 per 1,000 cases)
  • Subacute sclerosing panencephalitis (SSPE) - rare but fatal late complication
  • Seizures

• Hematological complications:

  • Thrombocytopenia (occurs at a ratio of 1 per 3,000 cases and is more likely to affect children) 2

Evidence Supporting Pneumonia as the Most Common Complication

Multiple guidelines and research studies confirm pneumonia as the most common serious complication of measles:

1. The CDC reports that pneumonia accounts for most measles-associated morbidity and mortality 1.

2. A 2008 study found pneumonia to be the most common complication (39.7%) among hospitalized measles patients, followed by diarrhea (38.2%) 3.

3. A 2019 publication specifically identifies pneumonia as "one of the most lethal complications" of measles 4.

High-Risk Groups for Complications

Certain populations are at increased risk for developing severe complications from measles:

• Infants and young children
• Adults
• Pregnant women
• Immunocompromised individuals
• Malnourished children

Prevention and Management

Prevention through vaccination is the most effective strategy against measles and its complications. The two-dose MMR vaccine schedule is recommended with 95-98% efficacy 1.

For confirmed cases with complications:

• Vitamin A supplementation is crucial for reducing mortality and morbidity
• Antibiotics should be administered for secondary bacterial infections like pneumonia
• Supportive care including hydration and nutritional support

Clinical Pearls

• Pneumonia in measles can be caused by the virus itself or by secondary bacterial infection
• Measles-associated pneumonia can progress to acute respiratory distress syndrome (ARDS) in severe cases
• Early recognition and management of respiratory symptoms is critical to prevent mortality
• Vitamin A supplementation significantly reduces the risk of complications and mortality

In conclusion, while measles can cause multiple complications including myocarditis, appendicitis, and immune thrombocytopenic purpura, pneumonia is definitively the most common complication and accounts for the majority of measles-related deaths worldwide.