Diagnosis: Measles.
Immunoglobulin M for measles was positive in this patient, with a titer ratio of 3.2 (reference ratio <0.8). Immunoglobulin G for measles was negative.1
Maculopapular confluent rash over the trunk.
Key to diagnosis is the characteristic rash, which appears about 4 days after the onset of fever. It is an erythematous, maculopapular, confluent rash, which first appears over the face and spreads in a cephalocaudal direction, along with coryza and conjunctivitis (Figure 1) [1, 2]. The appearance of diarrhea and mild thrombocytopenia also supports the diagnosis. Differential diagnosis includes other viral exanthems, which can be distinguished by the appearance of characteristic rash on the fourth day of illness, and drug eruptions in which the eosinophil count is usually elevated.
Note
Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
