Preventable Pulmonary Sequelae of Measles: A Case Report of an Adult Patient With Cystic Bronchiectasis

TL;DR

This case report shows how a childhood measles infection led to chronic lung disease in an adult, emphasizing the importance of vaccination.

Contribution

The paper presents a rare case linking childhood measles to adult-onset bronchiectasis, highlighting preventable long-term complications.

Findings

A 65-year-old woman developed cystic bronchiectasis due to childhood measles pneumonia.

The case illustrates the severe and long-lasting pulmonary consequences of measles.

The patient's condition required long-term oxygen and ventilation due to progressive disease.

Abstract

Bronchiectasis is a chronic structural lung disease characterized by irreversible bronchial dilation and persistent productive cough. In non-cystic fibrosis cases, post-infectious etiologies must be considered. Measles, a preventable and highly contagious viral illness, can cause transient immunosuppression, predisposing individuals to secondary infections and long-term pulmonary complications, including non-cystic fibrosis bronchiectasis. Vaccination against measles significantly reduces the incidence of pulmonary complications, including pneumonia, and consequently the occurrence of bronchiectasis. Despite global vaccination efforts, with measles declared eliminated in the United States in 2000, declining vaccine coverage has led to outbreaks even in developed countries.

We present a 65-year-old non-smoking woman followed since 2009, presenting with chronic productive cough, recurrent respiratory infections, and progressive dyspnea. Initial diagnosis was bilateral cystic bronchiectasis, confirmed by high-resolution CT. The etiological workup identified bilateral cystic bronchiectasis secondary to severe measles pneumonia in childhood, confirmed serologically. The disease progressed with recurrent exacerbations, requiring multiple hospitalizations. Since 2019, she has been treated with inhaled colistimethate sodium due to chronic Pseudomonas aeruginosa colonization. Currently, due to disease progression with a consequent obstructive ventilatory pattern, she also requires long-term oxygen therapy and nocturnal bilevel non-invasive ventilation for chronic respiratory failure.

This case highlights the preventable long-term pulmonary consequences of measles, which, although rare, can be severe and cause significant morbidity. It reinforces the importance of maintaining sustained vaccination coverage to prevent not only acute infection but also the resurgence of post-infectious bronchiectasis. It also underscores the importance of thorough etiological investigation and highlights the increased risk of poor outcomes in older patients and those requiring oxygen therapy.

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