Acute infection with measles virus predisposes to mastoiditis with concomitant facial paralysis and neck abscess: A minireview of pathomechanism and diagnostic approach

Despite the availability of safe, reliable, and cost-effective measles vaccine, we continue to experience dreadful measles outbreaks with devastating multisystem complications, especially in the pediatric age group. In most instances, the complications arise from a late presentation or delayed institution of appropriate care. With co-existence of measles virus and bacteria in the middle ear, suppurative otitis media can involve the mastoid process and causes fatal complications that manifest late when the patient is in a dire state. This short review highlights the pathogenic mechanisms leading to mastoiditis, facial paralysis, and neck abscess following acute infection with the measles virus, and outlines some useful diagnostic tips. In this review, we searched the international electronic database (PubMed, Web of Science, and Embase) and Google Scholar for articles published on complications of acute measles infection. The keywords used were "mastoiditis", "mastoid antrum", "middle ear", "otitis media", "Bezold's abscess", "facial paralysis" with an operator "OR"; "AND" measles; with restriction to the English language. Also, we searched for similar information in the local clinical and virology journals databases. Thereafter, we reviewed the publications and we described the findings qualitatively. Keywords: Measles; mastoid antrum; middle ear; otitis media; Bezold's abscess; facial paralysis