oa Central African Journal of Medicine - Disseminated intravascular coagulation as a possible cause of death in severe measles

Volume 27, Issue 2
  • ISSN : 0008-9176



The phenomenon of disseminated intravascular coagulation (DIC) or consumptive coagulopathy has been known to us for many years and many reports have been written about it, including its division into the acute or compensated and chronic forms (M. Wintrobe et al 1975). It is thought that many factors that trigger the clotting mechanisms can precipitate DIC (Wynne et al 1977). DIC has been demonstrated experimentally in rabbits by Schwartzman. The features in man appear to be the same to the Schwartzman reaction in rabbits (Wynne et al 1977). Several observers have reported the occurrence of DIC as a concomitant of severe measles (McKay & Margarethen 1967; Davies et al 1978). A number of papers have been published on the clinical and biochemical manifestations of DIC. In our experience at the Beatrice Road Hospital (BRH) Salisbury, Zimbabwe it appears that in the recent measles epidemic, 1979, up to 35 out of the 83 patients who died, the cause of death was directly due to DIC as a result of measles or secondary to a complication of the measles. Some investigations for DIC were done on 8 patients all subsequently dying as a result of DIC. Two of the cases have been selected and are presented below, in which the cause of death was DIC. These two cases are typical of the many measles deaths in which apparent improvement was followed by sudden deterioration and death within 10-24 hours.

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