What are the other Names for this Condition? (Also known as/Synonyms)

• Enlarged Lymph Nodes due to Measles
• Measles causing Enlarged Lymph Nodes
• Measles Lymphadenitis

What is Measles Lymphadenopathy? (Definition/Background Information)

• Measles Lymphadenopathy is the inflammation and enlargement of lymph nodes due to underlying Measles, which is caused by a virus
• Measles is a highly-contagious infection of the respiratory system, caused by Rubeola virus. The virus spreads by contact with infected individuals through respiratory droplets (that are dispersed when the individual sneezes, coughs, or talks)
• The risk for Measles Lymphadenopathy is through the underlying Measles infection which may develop due to a lack of proper vaccination, having reduced immunity, traveling to places where the disease is rampant, and having severe vitamin A deficiency
• The signs and symptoms of Measles Lymphadenopathy include enlarged lymph nodes that are painless (seen in the armpits and groin area). However, the underlying Measles infection can cause fever, skin rash, sore throat, dry cough, runny nose, and redness of the eyes
• Symptomatic treatment for fever and antibiotics for secondary bacterial infections may be prescribed in case of Measles Lymphadenopathy. However, pregnant women and those with poor immune systems may be prescribed immune serum globulin (to reduce severity of Measles)
• The prognosis of Measles Lymphadenopathy generally depends upon the severity of the underlying signs and symptoms due to the viral infection. Once an individual gets infected, isolating the individual so that others are not infected is generally advisable
• Most individuals recover from Measles without any lasting after-effects, unless certain complications such as pneumonia or encephalitis develops
• Vaccinations are an excellent method of avoiding Measles infection. However, sometimes, the live vaccine administered for Measles can also cause lymphadenopathy, which will go away (subside) with time, without any treatment

Who gets Measles Lymphadenopathy? (Age and Sex Distribution)

• Measles Lymphadenopathy occurs due to underlying Measles, which is an infection generally affecting children
• However, any individual can contract the condition at any age, if they have not had Measles before, and/or if they have not been vaccinated
• Both males and females are at risk for the viral infection
• Measles occurs worldwide and there are no specific racial or ethnic group preferences

What are the Risk Factors for Measles Lymphadenopathy? (Predisposing Factors)

The main risk factor for Measles Lymphadenopathy is the underlying Measles (viral) infection. The following are the risk factors associated with Measles:

• Vaccination: Those who have not received the Measles-Mumps-Rubella (MMR) vaccination are at a high risk
• Travel: Those who travel to places where Measles is prevalent at higher incidences are more likely to contract it
• Vitamin A deficiency: Individuals who lack vitamin A in their diet are more likely to be affected by Measles
• The presence of certain underlying conditions such as HIV infection, AIDS, and leukemia
• Immunocompromised individuals (who have poor immunity)
• Malnutrition
• Pregnancy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Measles Lymphadenopathy? (Etiology)

Measles Lymphadenopathy is caused by a viral infection that results in swollen lymph nodes and other related signs and symptoms.

• Measles is a highly-contagious infection of the respiratory system caused by the Rubeola virus. The virus belongs to the genus morbillivirus and family paramyxoviridae
• The virus resides in the mucus of the nose and throat of an infected individual. It can spread from one individual to another by inhalation of the tiny infected droplets that gets mixed with the air, when an infected individual coughs, sneezes, or even talks
• The infection can also spread through contaminated surfaces and objects, when individuals touch their nose or mouth after touching infected objects or surfaces

What are the Signs and Symptoms of Measles Lymphadenopathy?

The signs and symptoms of Measles Lymphadenopathy may include:

• Lymphadenopathy or enlarged lymph nodes that may involve lymph nodes all over the body
• Commonly, the lymph nodes of the armpits (axilla), head and neck region, and groin (inguinal) are involved
• The swollen lymph nodes are generally painless

The underlying Measles infection signs and symptoms may be observed 14 days after exposure to the virus and they may include:

• Fever
• Dry cough, sore throat
• Runny nose
• Conjunctivitis or redness of the eyes
• Sensitivity to light
• Koplik’s spots: Small white spots with bluish-white centers appearing inside the mouth on the inner side of the cheek
• Skin rashes

How is Measles Lymphadenopathy Diagnosed?

A physician might make a diagnosis of Measles Lymphadenopathy based on:

• Complete physical examination with medical history review
• The physical examination may involve a study of the signs and symptoms such as:
  • Skin rashes
  • Koplik’s spots inside the mouth
• Blood test to confirm that the rashes are indeed caused by Measles

In majority of the cases, a lymph node biopsy is not performed for Measles Lymphadenopathy. However, if the signs and symptoms persist despite suitable treatment, then a biopsy may be undertaken to rule-out other causes of swollen glands (such as a lymphoma).

In case of a lymph node biopsy, the following information may be noted:

• Lymph node biopsy: A lymph node biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. The pathologist may use special techniques, such as immunohistochemistry stains, to help reveal the presence of the pathogen
• The lymph node biopsy may be performed through any of the following procedures:
  • Fine needle aspiration biopsy (FNAB): A device called a cannula is used to extract tissue or fluid from the lymph nodes
  • Lymph node core biopsy of the enlarged lymph node
  • Lymph node open biopsy of the enlarged lymph node

Note: When the pathologist examines the tissue under a microscope, typical giant cells are noted, called Warthin-Finkeldey giant cells.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Measles Lymphadenopathy?

Measles (causing Lymphadenopathy) may lead to following complications:

• Diarrhea
• Bacterial ear infection
• Bronchitis or inflammation of the voice box and lungs causing respiratory difficulties
• Pneumonia: This is more common in those with weak immune systems
• Measles may cause low count of platelets (that are essential for blood clotting)
• Encephalitis or inflammation of the brain that can cause:
  • Vomiting
  • Convulsions
  • Coma, and even death
• Pregnancy-related adverse health conditions such as:
  • Pregnancy loss
  • Preterm labor
  • Low birth weight baby

How is Measles Lymphadenopathy Treated?

The management of Measles Lymphadenopathy may include undertaking treatment of the underlying Measles infection. This involves the following measures:

• Post-exposure vaccination: When immunized individuals are infected with Rubeola virus, they may be vaccinated within 72 hours of exposure to the virus, in order to prevent Measles infection
• Immune serum globulin: It is an injection of proteins and antibodies that are given to pregnant women, infants, and immune compromised individuals to reduce the effect of Measles
• Administration of medications that may include:
  • For reducing fever: Acetaminophen, ibuprofen, and naproxen
  • Antibiotics are usually prescribed if there are bacterial infections such as pneumonia or ear infection
  • Vitamin A: Vitamin A deficiency can make one susceptible to Measles; hence, increasing vitamin A in the diet is advisable, in case of poor vitamin A intake

How can Measles Lymphadenopathy be Prevented?

The prevention of Measles infection can reduce the risk for Measles Lymphadenopathy, which may be achieved through the following measures:

• Vaccination: Any individual, born after 1957, and not vaccinated, as well as infants over 6 months old, are advised vaccination against Measles
• Isolation: Measles is a highly-contagious condition, and hence, any infected individual should be kept isolated in a separate room and treated accordingly

What is the Prognosis of Measles Lymphadenopathy? (Outcomes/Resolutions)

The prognosis of Measles Lymphadenopathy is based on the severity of the underlying Measles infection.

• The prognosis of Measles infection is usually excellent with suitable treatment. Most individuals are able to recover within 2 weeks
• However, the development of complications, such as pneumonia, encephalitis, seizures, and meningitis, may take place that can be serious
• In rare cases, acute encephalitis due to Measles is a complication that may cause coma or even lead to brain injury and death

Additional and Relevant Useful Information for Measles Lymphadenopathy:

General information on lymph nodes:

The lymph nodes are part of one’s immune system. The lymph nodes are present throughout the body, usually in groups. In normal healthy adults, one cannot feel (see or touch) the lymph nodes readily. However, if they are enlarged, they can be felt either by the individual himself/herself or by the healthcare provider.

Enlarged lymph nodes can occur in both benign and malignant conditions. Hence, the cause of enlarged lymph nodes should be evaluated. If no obvious cause for enlargement of lymph nodes is found, then the possibility of a lymph node malignancy should be ruled out.

In a majority of individuals, a lymph node swelling is caused by a benign process such as an inflammation or infection. In many cases, swollen lymph nodes are part of other signs and symptoms. This can help a healthcare provider arrive at a list of follow-up tests and ensure an accurate diagnosis. Superficial enlarged lymph nodes can be felt by the healthcare provider through palpation. Enlarged lymph nodes deep in the body are often detected by radiological studies such as X-rays, ultrasound scan, CT and MRI scans.

Some enlarged lymph nodes can be painful, while others may be painless. Depending upon the underlying cause, enlarged lymph nodes can be localized to a particular area of the body, or they can be generalized, meaning that they are present throughout the body.