An unfortunate case of measles infection in pregnancy mistaken for dengue fever

Abstract

We present an uncommon case of an acute respiratory illness in a pregnant tourist in her second trimester. She is of foreign descent and was travelling from the Middle East to Singapore. She was initially referred by the general practitioner in Singapore for suspected acute dengue fever in view of her symptoms of fever, rash and conjunctivitis. After the initial negative screen for dengue and respiratory multiplex, she was later tested for measles due to her travel history. She was finally confirmed with a positive measles polymerase chain reaction (PCR) test. Unfortunately, her pregnancy was complicated by a septic abortion on the 3rd day after admission, leading to a uterine curettage due to a retained placenta. She was discharged home in good condition after supportive treatment. With the resumption of global travel post the COVID-19 pandemic, it is important to be mindful that there is an expected rise in the incidence of other infectious diseases such as measles, and to remain vigilant with detailed clinical history taking in patients who are travelling from abroad. As there is no curative treatment of measles, an early clinical suspicion is crucial for an early diagnosis.