L.V. PUZYREVA^1, 2, E.A. FADYUSHINA², T.E. SHVETS¹, E.I. MARTYNENKO², E.A. GASHINA¹, E.F. LOBOVA¹, E.P. SAMBRATH², I.M. FLORIAN², M.V. TIKHONOVA²

 ¹Omsk State Medical University, Omsk

²City Children’s Clinical Hospital No. 3, Omsk

Contact details:

Puzyreva L.V. — MD, Head of the Department of Pediatric Infectious Diseases

Address: 2 Lenin St., 644099 Omsk, Russian Federation, tel.: +7-913-149-1232, e-mail: puzirevalv@mail.ru

The World Health Organization recommends that all countries monitor cases of acute flaccid paralysis (AFP), which is the main clinical manifestation of paralytic poliovirus infection. This will help control poliovirus circulation and develop appropriate prevention strategies. Acute flaccid paralysis can be caused not only by viruses but also by non-infectious causes (trauma, ischemia, demyelinating diseases, etc.).

The purpose — to describe clinical cases of AFP over a three-year period.

Material and methods. This is a simple, retrospective, continuous, descriptive study. We analyzed cases of AFP (n = 13) among patients hospitalized in a pediatric infectious disease’s hospital from 2021 to 2024, taking into account clinical, instrumental, and laboratory data.

Results. The mean age of patients was 4.8 ± 3.99 years. A seasonal pattern in the AFP cases was noted. The primary complaint was limb weakness and inability to move. In most children, neurological symptoms were preceded by fever, catarrhal changes, and exanthema. Further examination revealed a predominance of acute respiratory failure of enteroviral origin, manifested primarily by lower monoparesis. In two cases, Epstein — Barr virus infection was detected, manifesting as lower monoparesis and paraparesis. The most severe signs were those of cytomegalovirus infection, manifested as encephalomyelitis.

It is not always possible to identify the etiology of acute respiratory failure, even with a comprehensive patient examination. This is due to delayed examination and a wide range of etiological factors.

Conclusion. AFP is a preliminary diagnosis and is not problematic for a practicing physician. However, it requires urgent hospitalization for a comprehensive examination, differential and definitive diagnosis to ensure that no cases of polio are missed. Furthermore, appropriate and timely rehabilitation can improve functional status and quality of life, thereby reducing the incidence of disability among children.

Key words: acute flaccid paralysis, polyneuropathy, neuropathy, poliomyelitis, enterovirus, cytomegalovirus, Epstein — Barr virus, encephalomyelitis, myelitis.

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