Vaccine-associated paralytic poliomyelitis in an infant with perianal abscesses.
We describe a case of vaccine-associated paralytic poliomyelitis (VAPP) in a 7-month-old infant with perianal abscesses. The infant had suffered from perianal abscesses from 3 weeks after birth. The abscesses repeatedly developed and spontaneously drained through the orifice. Twenty-seven days before admission, a live attenuated oral poliovirus vaccine (OPV) was given to the infant for the first time for routine immunization. His body temperature rose to 38°C 19 days after receiving the OPV and fell 4 days later. Flaccid paralysis of the right leg appeared 26 days after receipt of the OPV. A Sabin type 3 poliovirus was isolated from a stool obtained at admission. The DNA sequences of the VP1 region of the isolated virus were more than 99% identical with those of the vaccine strain. Mild muscle atrophy with moderate motor impairment in the right leg persisted at 18 months of age. One VAPP case provoked by a perianal abscess has been reported from the United Kingdom. Database search revealed that one of nine VAPP cases reported during 2003-2008 in Japan had a perianal abscess. Taken together, these reports and our case imply that we should give OPV with caution to infants with a perianal abscess.
Higashigawa
Masamune
M
Department of Pediatrics, Yamada Red Cross Hospital, 810 Takabuku, Misono-cho, Ise, 516-0805, Japan, higashigawa@hotmail.com.
Maegawa
Kayoka
K
Honma
Hitoshi
H
Yoshino
Ayako
A
Onozato
Kaori
K
Nashida
Yuji
Y
Fujiwara
Takashi
T
Inoue
Masakazu
M
D000038:Abscess / Q000150:complications*; D001004:Anus Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D011051:Poliomyelitis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects*
D011055:Poliovirus Vaccine, Oral