RESPIRATORY-FAILURE COMPLICATING RUBEOLA

We reviewed the charts of 19 patients with the diagnosis of measles wh o were admitted to the pediatric intensive care unit for respiratory f ailure requiring intubation and mechanical ventilation. Patients studi ed were admitted during the period June 1989 to June 1990. The mean ag e was 19 months (range, 3 to 51 months). The cause for respiratory fai lure fell into two groups: 47 percent -developed pneumonitis and refra ctory hypoxemia. Patients with pneumonitis and hypoxemic respiratory f ailure had a 56 percent mortality. An oxygenation index of greater tha n 40 for 4 h separated survivors from nonsurvivors (oxygenation index = [mean airway pressure x FIO2/PaO2 X 1001). Patients with tracheitis alone all survived. In these patients the organism primarily responsib le was Staphylococcus aureus (70 percent). Two of the seven patients w ith S aureus tracheitis had signs and symptoms of toxic shock syndrome and we subsequently demonstrated toxic shock syndrome toxin 1 in both patients.