Factors associated with fatal cases of measles. A retrospective autopsy study.

Clinical and laboratory records at Red Cross War Memorial Children's Hospital, Cape Town, for the period 1976-1982 were reviewed to determine factors associated with fatal cases of measles. Pneumonia was found to be the commonest lethal complication of measles. Supervening infections by both viral (especially adenovirus and herpesvirus) and bacterial (especially Klebsiella species and Pseudomonas) agents played a prominent role in causing the deaths of children who had recently been infected with measles. Severe malnutrition was present with almost equal frequency among those dying of measles and those dying from other causes, but was significantly (P less than 0,02) less common in measles patients who survived. Peripheral lymphopenia and depletion of T-cell zones in the lymph nodes and spleen were more common in those who died from measles than in others.