TMSS Medical College Journal

Background: Measles is a highly contagious viral illness predominantly affecting children; however, outbreaks among adults have been increasingly reported in different regions of the world. Adult measles is often associated with more severe clinical manifestations and complications than childhood disease. This case series describes the clinical characteristics, laboratory findings, management, and outcomes of 15 adult measles patients admitted to the Medicine Inpatient Department of TMSS Medical College, Bangladesh. Materials and Methods: A prospective descriptive case series was done among 15 consecutive adult patients admitted with clinically and molecular test (Reverse Transcription Polymerase Chain Reaction, RT-PCR) confirmed measles between March and May 2026. Demographic data, clinical manifestations, laboratory investigations, treatment modalities, complications, and outcomes were analyzed. Results: The mean age of the patients was 26.8 ± 6.1 years (range 18-42 years). Nine (60%) were male and six (40%) were female. All patients presented with fever and generalized maculopapular rash. Other common symptoms included cough (80%), conjunctivitis (67%), coryza (60%), headache (53%), and sore throat (47%). Koplik spots were observed in six patients (40%). Laboratory findings revealed lymphopenia in seven patients (46.7%), elevated liver enzymes in five patients (33.3%), and thrombocytopenia in one patient (6.7%). Complications occurred in four patients, including pneumonitis 26.7% (n=4), otitis media 6.7% (n=1), and respiratory failure 6.7% (n=1). All patients recovered with supportive treatment, and no mortality was recorded. Conclusion: Adult measles remains an important differential diagnosis in adults presenting with acute febrile rash illness. Early recognition, isolation, and supportive management are crucial for preventing complications and controlling outbreaks.

Historically categorized as a childhood illness,measles among adult populations is increasinglyrecognized as a public health concern worldwide aswell as within South Asia.!? Widespread immunizationinitiatives have remarkably diminished the globalburden of the disease. However, sporadic outbreakspersist worldwide, predominantly driven bysuboptimal vaccination coverage or pockets ofincompletely vaccinated populations.” Measles is anacute, highly contagious viral infection caused by themeasles virus, a member of the Paramyxoviridae family.’ Classic clinical features typically include highfever, cough, coryza, conjunctivitis, and apathognomonic generalized maculopapular rash.° This demographic shift is clinically significant; asadult measles frequently manifests as a more severeclinical course.*’ Adults experience higher rates ofhospitalization and are significantly more susceptibleto debilitating complications, including pneumonitis,severe hepatitis, otitis media, and neurologicalsequelae.2*’ In Bangladesh, despite significant advancements in national immunization coverages,localized outbreaks continue to challenge public healthinfrastructure.*° To better understand these shiftingdynamics, this study presents a descriptive case seriesof fifteen adult measles patients admitted to theMedicine Inpatient Department of TMSS MedicalCollege Hospital in Bogura, Bangladesh. We evaluatedtheir clinical presentations, laboratory findings,associated complications, and therapeutic outcomes toinform better clinical management and outbreakcontrol strategies.