Kramarov Sergiy, Palatna Liudmyla, Shpak Iryna, Seriakova Iryna, Zakordonets Liudmyla, Verbova Liudmyla, Molodetskyi Oleksandr, Myroniak Liudmyla, Isayenko Tatiana
Department of Pediatric Infectious Diseases, Bogomolets National Medical University, Kyiv, Ukraine.
International European University, Kyiv, Ukraine.
Int Med Case Rep J. 2025 Jul 18;18:899-907. doi: 10.2147/IMCRJ.S526156. eCollection 2025.
Transverse myelitis is an urgent medical problem all over the world. Acute transverse myelitis is more common in children than in adults. Postvaccinal transverse myelitis is a rare complication of vaccination. In vaccine-associated paralytic poliomyelitis, the virus mosaically infects the motor neurons of the anterior horns of the spinal cord, resulting in asymmetric paralysis of predominantly proximal muscles.
The case of acute transverse myelitis in a 12-year-old child corresponds to the existing definition of a vaccine-associated paralytic poliomyelitis case: a temporal relationship between the onset of flaccid paralysis and the administration of oral polio vaccine and the duration of paralysis. The child developed flaccid paralysis 18 days after (August, 2024) the administration of oral polio vaccine and persisted for more than 60 days from the onset of the disease. Vaccine virus type 3 was isolated from the feces. However, the child received 2 doses of inactivated oral polio vaccine and 1 dose of bivalent (types 1 and 3) oral polio vaccine before the disease. The child did not have an increase in the titer of antibodies in paired sera to polioviruses types 1 and 3. Spinal cord magnetic resonance imaging revealed an intramedullary focus with hyperintense MR signal on 2WI, 2FS at the level of the spinal cord cone (Th-L), which spread across the entire diameter and unevenly accumulated paramagnetic. These changes were characteristic of acute transverse myelitis.
This article presents a clinical case of Acute transverse myelitis in a child after administration of live oral polio vaccine. We aimed to emphasize the importance of differential diagnosis of myelitis in a child who received OPV. This is important from the point of view of epidemiological surveillance of poliomyelitis and possible adverse reactions after vaccination.
横贯性脊髓炎是全球范围内的一个紧急医学问题。急性横贯性脊髓炎在儿童中比在成人中更常见。疫苗接种后横贯性脊髓炎是疫苗接种的一种罕见并发症。在疫苗相关麻痹型脊髓灰质炎中，病毒呈镶嵌状感染脊髓前角运动神经元，导致主要为近端肌肉的不对称麻痹。
一名12岁儿童的急性横贯性脊髓炎病例符合疫苗相关麻痹型脊髓灰质炎病例的现有定义：弛缓性麻痹发作与口服脊髓灰质炎疫苗接种之间的时间关系以及麻痹持续时间。该儿童在口服脊髓灰质炎疫苗接种后18天（2024年8月）出现弛缓性麻痹，自疾病发作起持续超过60天。从粪便中分离出3型疫苗病毒。然而，该儿童在患病前接种了2剂灭活口服脊髓灰质炎疫苗和1剂二价（1型和3型）口服脊髓灰质炎疫苗。该儿童针对1型和3型脊髓灰质炎病毒的配对血清抗体滴度未升高。脊髓磁共振成像显示在脊髓圆锥（Th-L）水平的2WI、2FS上有一个髓内病灶，其MR信号呈高强化，病灶横跨整个直径且不均匀地积聚顺磁性物质。这些改变是急性横贯性脊髓炎的特征。
本文介绍了一名儿童在口服减毒活脊髓灰质炎疫苗后发生急性横贯性脊髓炎的临床病例。我们旨在强调对接受口服脊髓灰质炎疫苗儿童的脊髓炎进行鉴别诊断的重要性。从脊髓灰质炎的流行病学监测以及疫苗接种后可能的不良反应角度来看，这一点很重要。
