American Medical Association Family Medical Guide - American Medical Association [218]
Post-Polio Syndrome
Post-polio syndrome is a condition that affects about 25 percent of people who have recovered from polio. The syndrome, which occurs from 10 to 40 years after having polio, results from the death of motor neurons (nerve cells in the brain and spinal cord that control muscle activity) that did not die in the initial infection.
The symptoms of post-polio syndrome can include fatigue, slowly progressing muscle weakness, muscle and joint pain, difficulty swallowing, difficulty breathing, and, sometimes, muscle atrophy (shrinking or wasting of the muscles). The severity of the symptoms depends on the severity of the initial polio infection. Post-polio syndrome usually is not life-threatening unless a person’s breathing becomes severely impaired.
To diagnose post-polio syndrome, a doctor usually orders tests such as an MRI (see page 113) to look for changes in the brain or spine or to rule out other possible neurological disorders, an examination of the electrical activity of the brain (electroencephalogram; see page 687), and a muscle biopsy (microscopic examination of small samples of muscle tissue). He or she may order a lumbar puncture, in which a hollow needle is inserted into the lower back to remove a small sample of cerebrospinal fluid (the fluid that surrounds the brain and spinal cord) for examination under a microscope.
There is no treatment for post-polio syndrome, and the condition cannot be prevented. For some people, a healthy diet and regular moderate exercise may help reduce the severity of the symptoms. People with impaired breathing may need a ventilator (an artificial breathing machine) to assist with breathing. Research to develop medications to relieve symptoms or to slow or reverse progression of the disease is ongoing.
Diagnosis and Treatment
A diagnosis of polio is based on the symptoms and the results of a physical examination. The doctor may take a small sample of stool for microscopic examination to check for the virus. He or she may recommend a lumbar puncture (see page 693) to detect the virus in cerebrospinal fluid (the liquid that surrounds the brain and spinal cord).
There is no effective treatment for polio. If a child has paralysis, he or she may be hospitalized and undergo physical therapy. If a child has difficulty breathing, he or she may be placed on a ventilator (an artificial breathing machine) to assist with breathing.
Scarlet Fever
Scarlet fever is a contagious bacterial infection of the throat that is caused by group A streptococci. Without prompt treatment with antibiotics, the bacteria multiply and produce a toxin that circulates in the blood. The two main complications of scarlet fever are rheumatic fever (see page 432), an inflammatory disease that affects tissues and organs throughout the body, and poststreptococcal glomerulonephritis (see page 428), inflammation of the filtering units of the kidneys (glomeruli).
Symptoms
The symptoms of scarlet fever can vary from child to child. However, in most cases, on the first day of the infection, a child develops a high fever (a temperature up to 104°F) and a red, sore throat and tonsils. Other possible symptoms include chills, body aches, loss of appetite, nausea, and vomiting. A whitish or yellowish coating may cover the tongue and tonsils.
On the second day, a bright red (scarlet), sometimes itchy rash that looks and feels like sandpaper appears on the child’s face, except for the area just around the mouth. By the third day, the rash spreads to the child’s neck, chest, back, arms, and legs. At the same time, the child’s temperature begins