[Respiratory sequelae of severe measles (author's transl)].

Six healthy children, 5 boys and 1 girl aged from 13 months to 4 years had a severe measles bronchopneumonia. The end result is established chronic airflow obstruction. On a background of fairly severe respiratory failure there were paroxysms of breathlessness with fever, wheezes and cyanosis which were little affected by bronchodilators or steroids. The anatomical basis of this syndrome is before all else a bronchiolar obstruction, shown at autopsy in a child dying after four months of the illness. But also there is a disorder of the large bronchi with bronchiectasis and problems with ventilation centrally and/or peripherally. The major radiological signs are airways distension which is always clearly in keeping with emphysema and a thickening of the peri-bronchial walls which are clearly visible on tomography. Thus it appears that measles, as with other respiratory viruses, can lead to permanent sequelae in very young children. It is however possible that the respiratory sequelae may be due to associated viral infections, with adenovirus in particular. On the practical level, the occurrence of an early and severe measles pneumonia in a young child and its persistence with a hypoxia and a lowering of dynamic compliance requires a prolonged follow up and a guarded prognosis. Unfortunately the treatment of this type of chronic airflow obstruction is only symptomatic.