Poliovirus/Poliomielitis

Clasificación

Características Generales y Epidemiología

Características generales del poliovirus Poliovirus Poliomyelitis is an infectious disease caused by the poliovirus. This virus is a member of the Picornaviridae family. It is a small, single-stranded, positive-sense RNA virus without a lipid envelope. Transmission occurs through the fecal-oral route and, occasionally, through respiratory aerosols. Poliovirus/Poliomyelitis

• Familia: Picornaviridae Picornaviridae A family of small RNA viruses comprising some important pathogens of humans and animals. Transmission usually occurs mechanically. There are nine genera: aphthovirus; cardiovirus; enterovirus; erbovirus; hepatovirus; kobuvirus; parechovirus; rhinovirus; and teschovirus. Coxsackievirus
• Género: Enterovirus Enterovirus A genus of the family picornaviridae whose members preferentially inhabit the intestinal tract of a variety of hosts. The genus contains many species. Newly described members of human enteroviruses are assigned continuous numbers with the species designated ‘human enterovirus’. Coxsackievirus
• Clasificado como una cepa de Enterovirus C Enterovirus C A species of enterovirus infecting humans and containing 11 serotypes, all coxsackieviruses. Poliovirus/Poliomyelitis
• Virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de ARN:
  • Lineal
  • Monocatenario
  • Sentido positivo
  • Funciona como ARNm
• Diámetro: 25–30 nm
• Simetría icosaédrica
• Carece de envoltura lipídica
• Estable al AL Amyloidosis ácido

Especies clínicamente relevantes

La poliomielitis es causada por 3 serovares de poliovirus Poliovirus Poliomyelitis is an infectious disease caused by the poliovirus. This virus is a member of the Picornaviridae family. It is a small, single-stranded, positive-sense RNA virus without a lipid envelope. Transmission occurs through the fecal-oral route and, occasionally, through respiratory aerosols. Poliovirus/Poliomyelitis:

• Tipo salvaje 1 (más común)
• Tipos salvajes 2 y 3 (considerados erradicados)

Epidemiología

• El poliovirus Poliovirus Poliomyelitis is an infectious disease caused by the poliovirus. This virus is a member of the Picornaviridae family. It is a small, single-stranded, positive-sense RNA virus without a lipid envelope. Transmission occurs through the fecal-oral route and, occasionally, through respiratory aerosols. Poliovirus/Poliomyelitis se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia erradicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mayoría de los LOS Neisseria países gracias a los LOS Neisseria amplios esfuerzos de vacunación.
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2019 se registraron150 casos.
• Los LOS Neisseria países endémicos incluyen:
  • Pakistán
  • Afganistán

Patogénesis

Reservorio

Los LOS Neisseria humanos son el único reservorio conocido.

Transmisión

Este virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology altamente contagioso se transmite a través de:

• Vía fecal-oral
• Aerosoles respiratorios

Fisiopatología

• Entrada oral del virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology → replicación en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria tejidos linfáticos orofaríngeos y gastrointestinales
• Viremia Viremia The presence of viruses in the blood. Erythema Infectiosum asintomática → sistema reticuloendotelial
• Si la infección no es contenida → ocurre viremia Viremia The presence of viruses in the blood. Erythema Infectiosum secundaria → síntomas virales.
• El virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology ingresa al AL Amyloidosis SNC (proceso poco claro).
• La replicación viral ocurre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las neuronas de la columna (particularmente el cuerno anterior) y el tronco encefálico → daño y necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage → signos y síntomas neurológicos.

Presentación Clínica y Diagnóstico

Poliomielitis abortiva

La mayoría de los LOS Neisseria pacientes infectados son asintomáticos o desarrollan una enfermedad leve similar a la gripe:

• Fiebre
• Malestar
• Cefalea
• Faringitis
• Náuseas y vómitos

Poliomielitis no paralítica

Aproximadamente el 4% de los LOS Neisseria infectados desarrollará poliomielitis no paralítica. La presentación será una meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis aséptica después de un pródromo similar al AL Amyloidosis de la poliomielitis abortiva.

• Fiebre
• Cefalea
• Rigidez nucal

Poliomielitis paralítica

Una minoría de pacientes con poliomielitis no paralítica progresará a la forma paralítica de la enfermedad, caracterizada por:

• Espasmos musculares
• Mialgias
• Debilidad muscular profunda y asimétrica:
  • Piernas afectadas con mayor frecuencia
  • Más severa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria músculos proximales
• Reflejos disminuidos o ausentes
• Examen sensorial normal
• Retención urinaria
• Participación bulbar:
  • Disfagia
  • Afonía
  • Dificultad para manejar las secreciones
  • Compromiso respiratorio
  • Disfunción autonómica

Síndrome pospoliomielitis

El síndrome pospoliomielitis se manifiesta como un empeoramiento de los LOS Neisseria síntomas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria supervivientes de poliomielitis. Puede ocurrir décadas después de la infección inicial.

• Fatiga
• Debilidad progresiva y atrofia de los LOS Neisseria músculos afectados
• Fasciculaciones
• Dolor Dolor Inflammation
• Síndrome de la pierna inquieta
• Insuficiencia respiratoria

Diagnóstico

El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la presentación clínica y está respaldado por la evaluación diagnóstica.

Punción lumbar:

• A menudo se realiza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el contexto de meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis aséptica.
• Hallazgos:
  • Pleocitosis moderada
  • ↑ Proteína
  • Glucosa normal

Pruebas específicas:

• Cultivo viral
  • Aislamiento viral en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum heces: estándar de oro
  • También puede realizarse con secreciones/hisopados faríngeos.
• PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)
• Serología

Tratamiento y Prevención

Tratamiento

No existe una terapia antiviral Antiviral Antivirals for Hepatitis B eficaz para la poliomielitis. El tratamiento es de soporte.

• Vigilancia hemodinámica estrecha para pacientes con afectación bulbar
• Ventilación mecánica para insuficiencia respiratoria o protección de las vías respiratorias
• Analgésicos para el dolor Dolor Inflammation
• Férulas para prevenir deformidades

Pronóstico

Los LOS Neisseria pacientes con poliomielitis no paralítica se recuperan por completo. Para aquellos con poliomielitis paralítica:

• Mortalidad (casos paralíticos):
  • 2-5 % en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños y hasta un 15-30 % en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adolescentes/adultos
    • Aumenta al AL Amyloidosis 25-75 % con afectación bulbar
  • 30-40 % desarrollará síndrome pospoliomielitis

Prevención

Se utilizan 2 vacunas:

• Salk Salk A suspension of formalin-inactivated poliovirus grown in monkey kidney cell tissue culture and used to prevent poliomyelitis. Poliovirus/Poliomyelitis (vacuna antipoliomielítica inactivada):
  • Administrada por vía parenteral
  • Forma solo anticuerpos IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis, no IgA IgA Represents 15-20% of the human serum immunoglobulins, mostly as the 4-chain polymer in humans or dimer in other mammals. Secretory iga is the main immunoglobulin in secretions. Immunoglobulins: Types and Functions
• Sabin Sabin A live vaccine containing attenuated poliovirus, types I, II, and III, grown in monkey kidney cell tissue culture, used for routine immunization of children against polio. This vaccine induces long-lasting intestinal and humoral immunity. Killed vaccine induces only humoral immunity. Oral poliovirus vaccine should not be administered to immunocompromised individuals or their household contacts. Poliovirus/Poliomyelitis (vacuna oral contra el poliovirus Poliovirus Poliomyelitis is an infectious disease caused by the poliovirus. This virus is a member of the Picornaviridae family. It is a small, single-stranded, positive-sense RNA virus without a lipid envelope. Transmission occurs through the fecal-oral route and, occasionally, through respiratory aerosols. Poliovirus/Poliomyelitis):
  • Vida atenuada
  • Crea IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis e IgA IgA Represents 15-20% of the human serum immunoglobulins, mostly as the 4-chain polymer in humans or dimer in other mammals. Secretory iga is the main immunoglobulin in secretions. Immunoglobulins: Types and Functions
  • No se usa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria Estados Unidos.
  • Los LOS Neisseria pacientes excretan el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology → puede mutar y circular.

Comparación de Enterovirus

Diagnóstico Diferencial

• Síndrome de Guillain-Barré: Neuropatía inflamatoria adquirida aguda, rápidamente progresiva, que puede ser desencadenada por patógenos infecciosos. A diferencia de la poliomielitis, la debilidad muscular progresiva en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el síndrome de Guillain-Barré es simétrica, hay pérdida sensorial y la fiebre es rara. El diagnóstico es clínico. Una punción lumbar mostrará un recuento de leucocitos normal y proteínas elevadas (disociación albuminocitológica). El tratamiento requiere soporte de cuidados intensivos, inmunoglobulina IV e intercambio de plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products.
• Infección por virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology del Nilo Occidental: Infección por un flavivirus Flavivirus A genus of flaviviridae containing several subgroups and many species. Most are arboviruses transmitted by mosquitoes or ticks. The type species is yellow fever virus. Tick-borne Encephalitis Virus. La mayoría de los LOS Neisseria pacientes con el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology del Nilo Occidental serán asintomáticos o tendrán cefalea, mialgias y artralgias, vómitos, diarrea o erupción. Una pequeña proporción desarrolla encefalitis, meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis o parálisis flácida. El diagnóstico se puede realizar con serología, PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) y cultivos virales. Esto diferenciará el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology del Nilo Occidental de la poliomielitis. El tratamiento es de soporte.
• Porfiria aguda intermitente: Enfermedad autosómica dominante rara que produce una deficiencia de hidroximetilbilano sintasa. Esta deficiencia conduce a la acumulación de precursores del hemo. Los LOS Neisseria pacientes pueden experimentar dolor Dolor Inflammation abdominal, síntomas psiquiátricos y neuropatías periféricas que pueden simular el síndrome de Guillain-Barré. Puede ocurrir progresión a cuadriplejía e insuficiencia respiratoria. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niveles elevados de precursores de porfirina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina. El tratamiento incluye hemo IV, dextrosa y evitación de desencadenantes.
• Distrofia muscular: Grupo de trastornos musculares no inflamatorios provocados por una mutación en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el gen DMD DMD Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disorder that is caused by a mutation in the dmd gene. The mutation leads to the production of abnormal dystrophin, resulting in muscle-fiber destruction and replacement with fatty or fibrous tissue. Duchenne Muscular Dystrophy. Esta mutación conduce a la destrucción y sustitución de las fibras musculares por tejido graso o fibroso. Los LOS Neisseria pacientes se presentan con debilidad progresiva de los LOS Neisseria músculos proximales, que conduce a la eventual pérdida de la deambulación, así como contracturas, escoliosis, miocardiopatía e insuficiencia respiratoria. A diferencia de la poliomielitis, se puede observar una marcada elevación de la creatina cinasa. Las pruebas genéticas confirman el diagnóstico. El tratamiento es de soporte.
• Esclerosis múltiple: Enfermedad autoinmune inflamatoria crónica que conduce a la desmielinización del SNC. La presentación clínica de la esclerosis múltiple varía según el sitio de las lesiones, pero puede incluir síntomas neurológicos que afectan a la visión, las funciones motoras, la sensibilidad y la función autónoma. El diagnóstico se realiza con una RM del cerebro y la columna, así como con un examen del LCR. El tratamiento incluye corticosteroides para las exacerbaciones agudas y agentes modificadores de la enfermedad para ralentizar la progresión de la enfermedad.