Poliomyelitis, acute

Poliomyelitis, acute - Acute
Rahul Soman, M. Pharm

 

Definition  

A highly contagious infectious disease caused by poliovirus, an enterovirus, that can cause damage to the motor neurons of the anterior horn and brain stem

 

Medical History  

* Polio contact

 

Findings  

* Fever

* Headache

* Lymphadenopathy - Acute

* Loss of appetite

* Nausea and vomiting - Acute

* Constipation

* Pharyngitis - Acute

* Myalgia

* Muscle weakness

* Skeletal muscle spasm

* Kernig's sign

* Stiff neck

* Difficulty speaking

* Dysphagia

* Reflex finding

* Hypertension

* Hypotension

* Sensory disturbance in limb

* Paralysis

* Respiratory insufficiency

 

Tests  

 

Suspected acute poliovirus infection  

* Enterovirus culture: Two separate stool cultures provides a greater yield than 2 throat cultures. Cerebrospinal fluid cultures are rarely positive .

 

Determination of isolated poliovirus serotype and differentiation of wild-type and vaccine-strain virus .  

* Enterovirus polymerase chain reaction

 

Suspected acute poliovirus infection  

* Poliovirus antibody level: Neutralization of sera against paired antigens of the 3 poliovirus serotypes may produce a serological diagnosis .

 

Suspected acute poliovirus infection  

* Cerebrospinal fluid examination: Nonspecific findings in the cerebrospinal fluid include moderate pleocytosis and mild elevation of protein .

 

Evaluation of acute flaccid paralysis and suspected poliomyelitis  

* Electromyography

 

Differential Diagnosis  

* Guillain-Barré syndrome - Acute

* Disease due to West Nile virus - Acute

* Tick paralysis

* Familial periodic paralysis

* Porphyria

* Rhabdomyolysis - Acute

* Abortive poliomyelitis

* Nonparalytic poliomyelitis, acute

* Paralytic poliomyelitis, acute

* Paralytic poliomyelitis, vaccine-associated, acute

 

Treatment  

 

Procedural Therapy  

 

Respiratory distress  

* Airway management: Airway management must assume the first priority in the management of any seriously ill or injured patient .

 

Poliovirus infection  

* Physical therapy procedure

 

Reportable infectious diseases  

* Infectious disease notification: In the United States, specific infectious diseases must be reported to the state or local public health department .

 

Non-Procedural Therapy  

 

Acute poliomyelitis  

* Bedrest