Polio differential diagnosis: Difference between revisions
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{{CMG}}; {{AE}} {{JS}} | {{CMG}}; {{AE}} {{JS}} | ||
==Overview== | ==Overview== | ||
Abortive poliomyelitis must be differentiated from other diseases that cause: fever, nausea, vomiting, diarrhea, headache and sore throat, such as: gastroenteritis, or acute respiratory infection. | Abortive poliomyelitis must be differentiated from other diseases that cause: fever, nausea, vomiting, diarrhea, headache and sore throat, such as: gastroenteritis, or acute respiratory infection.<ref>{{cite journal |author=Falconer M, Bollenbach E |title=Late functional loss in nonparalytic polio |journal=American journal of physical medicine & rehabilitation / Association of Academic Physiatrists |volume=79 |issue=1 |pages=19–23 |year=2000 |pmid=10678598}}</ref><ref name="pmid2929811">{{cite journal| author=Sutter RW, Brink EW, Cochi SL, Kew OM, Orenstein WA, Biellik RJ et al.| title=A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases. | journal=Am J Public Health | year= 1989 | volume= 79 | issue= 4 | pages= 495-8 | pmid=2929811 | doi= | pmc=PMC1349984 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2929811 }} </ref> | ||
Non-paralytic poliomyelitis must be differentiated from other diseases that cause: [[fever]]; [[headache]]; [[myalgia]]; [[vomiting]]; [[lethargy]]; and [[muscle spasms]], such as: | Non-paralytic poliomyelitis must be differentiated from other diseases that cause: [[fever]]; [[headache]]; [[myalgia]]; [[vomiting]]; [[lethargy]]; and [[muscle spasms]], such as:<ref>{{cite journal |author=Falconer M, Bollenbach E |title=Late functional loss in nonparalytic polio |journal=American journal of physical medicine & rehabilitation / Association of Academic Physiatrists |volume=79 |issue=1 |pages=19–23 |year=2000 |pmid=10678598}}</ref><ref name="pmid2929811">{{cite journal| author=Sutter RW, Brink EW, Cochi SL, Kew OM, Orenstein WA, Biellik RJ et al.| title=A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases. | journal=Am J Public Health | year= 1989 | volume= 79 | issue= 4 | pages= 495-8 | pmid=2929811 | doi= | pmc=PMC1349984 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2929811 }} </ref> | ||
Paralytic poliomyelitis must be differentiated from other diseases that cause: [[headache]], [[muscle pain]]; [[lethargy]], [[muscle weakness]], [[muscle spasms|spams]] and [[tremors]], such as: [[Guillain-Barré syndrome]]; traumatic [[neuritis]] of the [[sciatic nerve]]; and [[transverse myelitis]]. | Paralytic poliomyelitis must be differentiated from other diseases that cause: [[headache]], [[muscle pain]]; [[lethargy]], [[muscle weakness]], [[muscle spasms|spams]] and [[tremors]], such as: [[Guillain-Barré syndrome]]; traumatic [[neuritis]] of the [[sciatic nerve]]; and [[transverse myelitis]].<ref>{{cite journal |author=Falconer M, Bollenbach E |title=Late functional loss in nonparalytic polio |journal=American journal of physical medicine & rehabilitation / Association of Academic Physiatrists |volume=79 |issue=1 |pages=19–23 |year=2000 |pmid=10678598}}</ref><ref name="pmid2929811">{{cite journal| author=Sutter RW, Brink EW, Cochi SL, Kew OM, Orenstein WA, Biellik RJ et al.| title=A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases. | journal=Am J Public Health | year= 1989 | volume= 79 | issue= 4 | pages= 495-8 | pmid=2929811 | doi= | pmc=PMC1349984 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2929811 }} </ref><ref name="pmid8442872">{{cite journal| author=Alcalá H| title=[The differential diagnosis of poliomyelitis and other acute flaccid paralyses]. | journal=Bol Med Hosp Infant Mex | year= 1993 | volume= 50 | issue= 2 | pages= 136-44 | pmid=8442872 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8442872 }} </ref> | ||
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Of the 246 children, 42 has poliomyelitis (17%); 156 has Guillain-Barré syndrome (GBS) (63.4%); 16 had traumatic neuritis of the sciatic nerve secondary to IM injections (TNC) (6.5%); five had transverse myelitis (2%); the rest (27) had other diseases misdiagnosed as polio (10.9%). The basic clinical characteristics for the diagnosis of poliomyelitis are: myalgias and fever at the onset AFP, paralysis is asymmetrical, of distal predominance and causes severe muscular atrophy and skeletal deformities; the GBS presents as an ascending, symmetrical, areflexic paralysis of distal predominance. It does not causes atrophy or deformities. TNC presents several days after IM injections with pain and hypothermia in the affected limbs; TM is a flaccid, symmetrical paraparesis with neurogenic bladder and a sensory level. CSF and neurophysiological studies (EMG and NCV) are very useful for diagnosis. Other entities misdiagnosed as poliomyelitis were: osteoarticular trauma, myopathies and dystrophies, viral myositis, acute cerebellitis, retroperitoneal tumors and upper motor neuron syndromes. Viral studies in stool specimens are essential for the diagnosis of poliomyelitis | Of the 246 children, 42 has poliomyelitis (17%); 156 has Guillain-Barré syndrome (GBS) (63.4%); 16 had traumatic neuritis of the sciatic nerve secondary to IM injections (TNC) (6.5%); five had transverse myelitis (2%); the rest (27) had other diseases misdiagnosed as polio (10.9%). The basic clinical characteristics for the diagnosis of poliomyelitis are: myalgias and fever at the onset AFP, paralysis is asymmetrical, of distal predominance and causes severe muscular atrophy and skeletal deformities; the GBS presents as an ascending, symmetrical, areflexic paralysis of distal predominance. It does not causes atrophy or deformities. TNC presents several days after IM injections with pain and hypothermia in the affected limbs; TM is a flaccid, symmetrical paraparesis with neurogenic bladder and a sensory level. CSF and neurophysiological studies (EMG and NCV) are very useful for diagnosis. Other entities misdiagnosed as poliomyelitis were: osteoarticular trauma, myopathies and dystrophies, viral myositis, acute cerebellitis, retroperitoneal tumors and upper motor neuron syndromes. Viral studies in stool specimens are essential for the diagnosis of poliomyelitis | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Abortive poliomyelitis must be differentiated from other diseases that cause: fever, nausea, vomiting, diarrhea, headache and sore throat, such as: gastroenteritis, or acute respiratory infection.[1][2]
Non-paralytic poliomyelitis must be differentiated from other diseases that cause: fever; headache; myalgia; vomiting; lethargy; and muscle spasms, such as:[3][2]
Paralytic poliomyelitis must be differentiated from other diseases that cause: headache, muscle pain; lethargy, muscle weakness, spams and tremors, such as: Guillain-Barré syndrome; traumatic neuritis of the sciatic nerve; and transverse myelitis.[4][2][5]
Differential Diagnosis
Abortive Poliomyelitis
| Disease | Findings |
|---|---|
| Gastroenteritis | |
| Acute respiratory infection |
Non-Paralytic Poliomyelitis
| Disease | Findings |
|---|---|
| ' | |
| ' | |
| ' |
Paralytic Poliomyelitis
| Disease | Findings |
|---|---|
| Guillain-Barré syndrome | |
| Traumatic neuritis of the sciatic nerve | |
| Transverse myelitis |
References
- ↑ Falconer M, Bollenbach E (2000). "Late functional loss in nonparalytic polio". American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 79 (1): 19–23. PMID 10678598.
- ↑ 2.0 2.1 2.2 Sutter RW, Brink EW, Cochi SL, Kew OM, Orenstein WA, Biellik RJ; et al. (1989). "A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases". Am J Public Health. 79 (4): 495–8. PMC 1349984. PMID 2929811.
- ↑ Falconer M, Bollenbach E (2000). "Late functional loss in nonparalytic polio". American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 79 (1): 19–23. PMID 10678598.
- ↑ Falconer M, Bollenbach E (2000). "Late functional loss in nonparalytic polio". American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 79 (1): 19–23. PMID 10678598.
- ↑ Alcalá H (1993). "[The differential diagnosis of poliomyelitis and other acute flaccid paralyses]". Bol Med Hosp Infant Mex. 50 (2): 136–44. PMID 8442872.