Case 89. Measles pneumonia (9 y-o M)
Autopsy findings of measles-associated massive pneumonia
Key words : measles virus, giant cell pneumonia, RS virus
Features of giant cell interstitial pneumonia are observed. The alveolar pneumocytes transform into multinucleated giant cells (HE, low power).   Intranuclear inclusions are seen in the multinucleated pneumocytes, pathognomonic of measles pneumonia (HE, high power).
Measles NP antigens are demonstrated along the plasma membranes of the giant pneumocytes, as well as in their nuclear inclusions (immunostaining).   Reference case 89A
Another autopsy case (4 y-o M) of giant cell interstitial pneumonia without clinical features of measles. Formation of multinucleated giant cells along the markedly thickened alveolar septa is characteristic (HE). No nuclear inclusions are observed in this case. Infection of respiratory syncytial (RS) virus is strongly suspected.