Sigmund J, Guggenbichler J P
Padiatr Padol. 1985;20(1):77-82.
This is the report of a four months old boy who developed a serous meningitis and flaccid paralysis of the left upper and lower extremity 17 days following the first immunisation with a trivalent life poliomyelitis vaccine. The patient recovered well within 2 months. Presently a mild functional disturbance and muscle wasting of the left leg can still be observed. An acute poliomyelitis can be due to a wild virus infection in an unimmunized child. Secondly an acute poliomyelitis can occur as vaccine associated poliomyelitis as it is reported in the immunocompromised host. As a third possibility the remutation of a poliomyelitis vaccine virus in a patient concomitantly infected with cytomegalovirus can be discussed. Our patient showed a normal humoral and cellular immunity. Virologic studies in our patient disclosed a wild poliomyelitis virus type III which was isolated from the stool. It cannot be clearly distinguished at the present time whether this wild virus is due to a remutation in the presence of a recent cytomegalovirus infection in our patient or due to a newly acquired wild virus infection.
这是一名4个月大男婴的报告，其在首次接种三价口服脊髓灰质炎活疫苗17天后发生了浆液性脑膜炎以及左上肢和下肢弛缓性麻痹。患者在2个月内恢复良好。目前仍可观察到左腿有轻度功能障碍和肌肉萎缩。急性脊髓灰质炎可能是由于未免疫儿童感染野生病毒所致。其次，急性脊髓灰质炎可能以疫苗相关脊髓灰质炎的形式出现，正如在免疫功能低下宿主中所报道的那样。作为第三种可能性，可以讨论脊髓灰质炎疫苗病毒在同时感染巨细胞病毒的患者中发生变异的情况。我们的患者表现出正常的体液免疫和细胞免疫。对我们患者的病毒学研究发现了从粪便中分离出的野生III型脊髓灰质炎病毒。目前尚不能明确区分这种野生病毒是由于我们患者近期感染巨细胞病毒时发生的变异，还是由于新获得的野生病毒感染。
