Miscellaneous Viral Infections

Abstract

Measles (Rubeola virus). Although rare, measles infection produces a number of gastrointestinal manifestations, including appendicitis, enteritis, and mesenteric lymphadenitis. Histologic findings in measles-related appendicitis include lymphoid hyperplasia and multinucleate Warthin–Finkeldey giant cells (Fig. 26.1), predominantly within germinal centers; associated inflammation is variably present. Although the measles virus probably does not independently cause true appendicitis, the lymphoid hyperplasia may lead to obstruction, acute inflammation, and even gangrenous appendicitis. Patients often have a concomitant rash, although the gastrointestinal morphologic findings may precede the viral xanthem, and serologic findings and immunohistochemistry can help confirm the diagnosis. Measles rarely has been reported to cause viral gastritis and enteritis, with symptoms including abdominal pain, diarrhea, and malabsorption.