Case report: Ribavirin and vitamin A in a severe case of measles

Amandine Bichon (1) , Camille Aubry (1) , Lucas Benarous (2) , Hortense Drouet (1) , Christine Zandotti (1) , Philippe Parola (1) , Jean-Christophe J.-C. Lagier (1)

1 URMITE - Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes
2 APHM - Assistance Publique - Hôpitaux de Marseille

Rationale: Despite a vaccine being widely available, measles continues to occur frequently, with sometimes lethal consequences. Patients concerns: The mortality rate reaches 35% and measles represents 44% of the 1.4 million deaths which are due to preventable diseases. Severe forms of measles are reported, mainly in young, unvaccinated adults, and in specific populations. The risk factors for severe measles include no or incomplete vaccination and vitamin A deficiency. Apart from secondary measles-related infections, severe measles is mainly represented by neurological, respiratory, and digestive symptoms. Diagnoses: Strengthening the hypothesis that there is a link between vitamin A deficiency and severe measles in this paper we report the case of a 25-year-old unvaccinated man hospitalized for severe and complicated measles. Outcomes: The evolution was good after administration of intramuscular vitamin A as well as intravenous ribavirin. Lessons: Measles remains a fatal and serious disease. The early use of ribavirin and vitamin A shows significant improvements regarding morbimortality and should be systematic in severe cases.

Mots clés: vitamin A deficiency; vitamin A therapy; ribavirin; severe measles; vaccine

Domaines: Médecine humaine et pathologie

Amandine Bichon, Camille Aubry, Lucas Benarous, Hortense Drouet, Christine Zandotti, et al.. Case report: Ribavirin and vitamin A in a severe case of measles. Medicine, 2017, 96 (50), ⟨10.1097/MD.0000000000009154⟩. ⟨hal-01729782⟩