Vaginal Mucositis in Measles

Background: Measles (rubeola), a common childhood exanthema, occurs infrequently in adults. Vaginal mucositis in association with measles is not commonly described. Case: During a recent measles epidemic, 2 female patients presented with high fever, myalgia, exanthema, and prostration. On examination, each patient had marked inflammation and tenderness of the vaginal mucosa, prompting the presumptive diagnosis of toxic shock syndrome. The evolution of the illness was consistent with measles. Cervicovaginal cultures were negative for pathogens. Acute and convalescent antibody titers for Rocky Mountain spotted fever, rubella, leptospirosis, and Proteus Ox-19 were not consistent with a recent infection. The sera also were negative for anti-toxic shock toxin-1 and anti-streptolysin. Measles antibody titers were consistent with a recent infection. Conclusion: Vaginal mucositis is an unusual manifestation of measles that may mimic toxic shock syndrome.