Fatal Measles Pneumonia Without Rash in a Child with AIDS

Severe measles illness in immunocompromised patients has been previously described. Death is frequently due to giant-cell pneumonia; however, fatal measles encephalitis has been reported. The severity and the manifestations of measles in immunocompromised patients are dependent on the type of immunodeficiency. Patients with B cell abnormalities appear to have typical measles illness, whereas those with T cell abnormalities have severe illness, frequently in the absence of rash. The authors describe a fatal case of measles pneumonia without rash in a child with acquired immunodeficiency syndrome (AIDS) and a subsequent nosocomial measles outbreak.