Poliovirus infection
- Overview
- Theory
- Diagnosis
- Management
- Follow up
- Resources
Algoritmo de tratamiento
Tenga en cuenta que las formulaciones/vías y dosis pueden diferir entre los nombres y marcas de los fármacos, las fórmulas de los fármacos o las localizaciones. Las recomendaciones de tratamiento son específicas para cada grupo de pacientes: ver aviso legal
gastrointestinal illness: poliovirus suspected
supportive care with rehydration + neurologic monitoring
Oral rehydration and/or intravenous fluids should be given to prevent volume depletion.
The patient should be monitored for acute flaccid paralysis (AFP), which indicates progression to paralytic poliomyelitis.
When poliovirus infection is suspected, the local health authority should be immediately notified: in the US, the local health department or the Centers for Disease Control and Prevention (CDC); in disease-endemic countries, the local office of the WHO.[1]Heymann DL, Aylward RB. Eradicating polio. N Engl J Med. 2004 Sep 23;351(13):1275-7. http://www.ncbi.nlm.nih.gov/pubmed/15385650?tool=bestpractice.com
paralytic poliomyelitis (acute flaccid paralysis)
supportive care with physical therapy + mobilization
Supportive treatment entails early physical therapy and mobilization.
The patient should be monitored for progression of limb paralysis to respiratory paralysis.
When poliovirus infection is diagnosed or suspected, the local health authority should be immediately notified. In the US, this will be the local health department or the Centers for Disease Control and Prevention (CDC); in disease-endemic countries, the local office of the WHO.[1]Heymann DL, Aylward RB. Eradicating polio. N Engl J Med. 2004 Sep 23;351(13):1275-7. http://www.ncbi.nlm.nih.gov/pubmed/15385650?tool=bestpractice.com
transfer to specialized center ± intubation
Se recomienda el tratamiento para TODOS LOS pacientes en el grupo de pacientes seleccionados
Respiratory paralysis is a life-threatening condition requiring expert medical assistance, and immediate transport to a specialized center for treatment is required..
Respiratory support measures include intubation and ventilation as needed.[1]Heymann DL, Aylward RB. Eradicating polio. N Engl J Med. 2004 Sep 23;351(13):1275-7. http://www.ncbi.nlm.nih.gov/pubmed/15385650?tool=bestpractice.com [48]Miller AH, Buck LS. Tracheotomy in bulbar poliomyelitis. Calif Med. 1950 Jan;72(1):34-6. https://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1520308&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/15398892?tool=bestpractice.com
postpoliomyelitis syndrome (PPS)
supportive care with physical therapy + mobilization
PPS may develop many years or even decades following paralytic poliomyelitis, and consists of fatigue, weakness, and wasting of affected muscles. Ongoing physical therapy and mobilization are required.[43]Ramaraj R. Post-poliomyelitis syndrome: clinical features and management. Br J Hosp Med. 2007 Dec;68(12):648-50. http://www.ncbi.nlm.nih.gov/pubmed/18186398?tool=bestpractice.com [49]Bruno RL. Post-polio syndrome. Neurology. 1996 Nov;47(5):1359-60. http://www.ncbi.nlm.nih.gov/pubmed/8909477?tool=bestpractice.com [50]Farbu E, Gilhus NE, Barnes MP, et al. Post-polio syndrome: EFNS guidelines on post-polio syndrome. In: Gilhus NE, Barnes MP, Brainin M, eds. European Handbook of Neurological Management, Volume 1. 2nd ed. West Sussex, UK: Blackwell Publishing Ltd.; 2011:311-9.
A systematic review on pharmacologic and nonpharmacologic therapies found insufficient good-quality evidence to make definite recommendations concerning the various treatments used for PPS.[51]Koopman FS, Beelan A, Gilhus NE, et al. Treatment for postpolio syndrome. Cochrane Database Syst Rev. 2015 May 18;(5):CD007818. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007818.pub3/full http://www.ncbi.nlm.nih.gov/pubmed/25984923?tool=bestpractice.com
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Tenga en cuenta que las formulaciones/vías y dosis pueden diferir entre los nombres y marcas de los fármacos, las fórmulas de los fármacos o las localizaciones. Las recomendaciones de tratamiento son específicas para cada grupo de pacientes. Véase el descargo de responsabilidad
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