COMPLICATIONS

The danger from measles depends almost entirely on its complications. In any case if fever persists after the rash fades and the patient does not rapidly improve complications must be suspected. Sometimes a looseness of the bowels occurs with the onset of measles, but it usually stops as the eruption comes out. In babies the intestinal disturbance may continue and grow worse as the disease progresses. This may become a grave complication in young children. Most often dangerous complications have to do with the respiratory tract. In small children there is a special tendency for the inflammation to extend from the bronchial tubes to the lungs with resulting pneumonia, which is the most common cause of death. Sometimes the inflammation extends to the covering of the lungs producing pleurisy. This may become purulent, and then is known as empyema. In this condition pus collects in the chest between the lung and the chest wall, causing compression of the lung. When the pleurisy begins there is pain in the side, but as the pus accumulates this stops. With the collection of pus in the side breathing is interfered with and in children especially the side affected may be seen to be enlarged and to move less than the other side when the patient breathes. This condition is associated with fever and sweats, and not infrequently has aroused suspicion of consumption.

Inflammation inside the ear is a frequent complication of measles. The involvement of the ear follows the passage of infectious material from the throat through the Eustachian tube. There is first fever and pain in the ear, which may subside, or after a day or two, a discharge from the ear appears. The discharge at first is watery and may be tinged with blood, but it soon becomes thick and purulent. With the appearance of discharge the pain subsides and the fever disappears. As healing takes place the discharge again becomes thinner and finally stops. Sometimes the inflammation extends from the ear to the bone back of the ear and mastoid disease results. This is recognized by tenderness on pressing on the bone. When this develops fever returns and the child appears sicker. With mastoid disease there is always danger of extension of the inflammation through the bone and the production of meningitis. Children with measles often have small whitish ulcers in the mouth, on the lining of the cheek, along the gums and on the edges and tip of the tongue. These are apt to be sensitive, causing pain when eating, and associated with profuse flow of saliva. Very rarely these ulcers become black and there results an extensive ulceration of the entire face. This occurs only in poorly nourished children, especially in institutions.

Measles has the property of rendering the patient susceptible to other contagious diseases. Tuberculosis often progresses rapidly after measles. This should always be suspected if fever and cough continue after the rash fades. If diphtheria is contracted during or soon after measles it runs a particularly virulent course. On the other hand when measles follows other contagious diseases, especially whooping cough, it is more fatal. Children with whooping cough should be kept away from measles with special care.