Polio physical examination
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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
Physical Examination
About 95% of patients with an healthy immune system are asymptomatic and have a normal physical examination.[1]
4 to 8% of poliovirus infection may lead abortive poliomyelitis, a mild symptomatic disease with little findings on physical exam. 2 to 3 days of fever may be the only finding.[2]
Poliovirus infection may cause non-paralytic (1-2%) or paralytic (<1%) forms of the disease. Physical findings in these forms of the disease may include:
Non-Paralytic Poliomyelitis
Meningeal signs may be present on physical exam, such as:[3]
Paralytic Poliomyelitis
Spinal Paralytic Poliomyelitis
Temperature
- A fever is often present
Extremities
- Weakness of the extremities, predominantly of the proximal muscles, is characteristic of this form of the disease. Lower extremities are more often involved.
- Asymmetrical flaccid paralysis, predominantly of the proximal muscles, is characteristic of this form of the disease. Lower extremities are more often involved.
Neurologic
- Meningeal signs may be present on physical exam, such as:[4]
- Initially hyperactive deep tendon reflexes, that later become absent.
- Common combinations of limb involvement include:
- One lower limb, followed by one upper limb
- Both lower limbs, followed by both upper limbs
- Quadriplegia is a rare finding in infants.
Bulbar Paralytic Poliomyelitis
Neurologic
- Pharyngeal paralysis, evidenced by accumulation of secretions is often present in this form of the disease.[5]
- Inability to swallow[6]
- In rare severe cases, respiratory centers may be affected, leading to inability to breathe.[7]
Polioencephalitis
References
- ↑ "Poliomyelitis".
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.