A 2-year-old unvaccinated child presents with 4 days of high fever, cough, coryza, conjunctivitis, and then a maculopapular rash starting behind the ears and spreading cephalocaudally. Koplik's spots are visible on the buccal mucosa. Which of the following complications is the MOST COMMON cause of death from measles in developing countries?

• A Measles encephalitis (post-infectious)
• B Subacute sclerosing panencephalitis (SSPE)
• C Secondary bacterial pneumonia ✓
• D Myocarditis

Explanation

Secondary bacterial pneumonia — caused by Streptococcus pneumoniae, Staphylococcus aureus, or Haemophilus influenzae — is the most common cause of measles-related mortality, accounting for approximately 75–90% of measles deaths in developing countries. Measles causes transient but severe immune suppression ('immune amnesia') that predisposes to secondary bacterial infections. SSPE is a rare late (7–10 years post-measles) fatal neurological complication. Measles encephalitis occurs in about 1:1000 cases.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.